Advanced Foot & Ankle Center SC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

748 Issued in WI

Legal business name

ADVANCED FOOT & ANKLE CENTER SC

Practice address

410 E 2ND St
Merrill, WI 54452-2319

Phone

(715) 536-7444

Fax

(715) 536-1547

NPI assigned

Jul 20, 2007

Last updated

Apr 7, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jeff Chism, DPM

Title

President

Phone

(715) 536-7444

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joel J Tikalsky, DPM

  • Podiatrist
  • Weston, WI
  • NPI 1073500526
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270598400000",
    "number": "1285834929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 E 2ND ST",
            "city": "MERRILL",
            "state": "WI",
            "postal_code": "54452",
            "telephone_number": "715-536-7444",
            "fax_number": "715-536-1547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 E 2ND ST",
            "city": "MERRILL",
            "state": "WI",
            "postal_code": "544522319",
            "telephone_number": "715-536-7444",
            "fax_number": "715-536-1547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED FOOT & ANKLE CENTER SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-20",
        "last_updated": "2010-04-07",
        "status": "A",
        "authorized_official_last_name": "CHISM",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "715-536-7444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WI",
            "license": "748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI BLUE SHIELD",
            "identifier": "000000485016",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC REGION B",
            "identifier": "1197940001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43223800",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "000086520",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abegglen Chiropractic Clinic Service Corporation
• Michael Gordon Aldrich, MD
• Miira Catherine Allen, D.P.T.
• Anderson & Associates Counseling and Psychologist Services LLC
• Amy Virginia Anderson, PTA
• Kathy Jo Anderson, PTA

• Podiatrist in Merrill, WI
• Providers in Merrill, WI by specialty
• Podiatrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.