South Side Foot and Ankle Clinic

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

07000810A Issued in IN

Legal business name

SOUTH SIDE FOOT AND ANKLE CLINIC

Practice address

3506 S Michigan St
South Bend, IN 46614-1728

Phone

(574) 231-1960

Fax

(574) 231-1961

NPI assigned

Jan 27, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Julie A Wieger, DPM

Title

Owner

Phone

(574) 231-1960

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1264550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264550400000",
    "number": "1295066546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3506 S MICHIGAN ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466141728",
            "telephone_number": "574-231-1960",
            "fax_number": "574-231-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3506 S MICHIGAN ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466141728",
            "telephone_number": "574-231-1960",
            "fax_number": "574-231-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SIDE FOOT AND ANKLE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-27",
        "last_updated": "2010-01-27",
        "status": "A",
        "authorized_official_last_name": "WIEGER",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-231-1960",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IN",
            "license": "07000810A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in South Bend, IN
• Providers in South Bend, IN by specialty
• Foot & Ankle Surgery Podiatrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.