Organization Active NPI

Metro Foot Specialists LLC

  • Foot & Ankle Surgery Podiatrist
  • Eureka, MO
National Provider Identifier
1336127208
Registry record updated Nov 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
METRO FOOT SPECIALISTS LLC
Practice address
521 N Virginia Ave
Eureka, MO 63025-1115
Phone
(636) 938-5006
Fax
(636) 587-3774
NPI assigned
Jan 2, 2006
Last updated
Nov 4, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2016

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

Authorized official

Name
Dr. Kra M Kozlowski, DPM,
Title
DPM, Facfas
Phone
(636) 938-5006

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X NU Primary

Addresses

Primary practice location

521 N Virginia Ave
Eureka, MO 63025-1115

Mailing address

62 E North St Ste 101
Eureka, MO 63025-1205
Phone (636) 938-5006

Other identifiers 2

IdentifierTypeStateIssuer
367176203MedicaidMO
367346509MedicaidMO

National Provider Directory

National Provider Directory

Locations

3927 Solutions Ctr
Chicago, IL 60677

62 E North St
Ste 101
Eureka, MO 63025
Phone (573) 783-7061

1747 Smizer Station Rd
Ste 3A
Fenton, MO 63026
Phone (636) 225-8855

NPI Registry JSON

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

{
    "created_epoch": "1136160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478217600000",
    "number": "1336127208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 E NORTH ST STE 101",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251205",
            "telephone_number": "636-938-5006",
            "fax_number": "636-587-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 N VIRGINIA AVE",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251115",
            "telephone_number": "636-938-5006",
            "fax_number": "636-587-3774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO FOOT SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-02",
        "last_updated": "2016-11-04",
        "status": "A",
        "authorized_official_last_name": "KOZLOWSKI",
        "authorized_official_first_name": "KRA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DPM, FACFAS",
        "authorized_official_telephone_number": "636-938-5006",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM,"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "367176203",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "367346509",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2016; 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.