NPIMap

Organization Active NPI

Missouri Delta Foot and Ankle Centers, Inc

Doing business as Foot and Ankle Centers of Southeast Missouri

  • Podiatrist
  • Sikeston, MO
National Provider Identifier
1346389749
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
MISSOURI DELTA FOOT AND ANKLE CENTERS, INC
Doing business as
Foot and Ankle Centers of Southeast Missouri
Practice address
522 Virginia St
Sikeston, MO 63801-5812
Phone
(573) 472-2202
Fax
(573) 472-3720
NPI assigned
Feb 5, 2007
Last updated
Jan 26, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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

Authorized official

Name
Dr. Hugh Raymond Protzel, DPMNPI 1134117328
Title
Owner
Phone
(573) 472-2202

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 000625 MO
Podiatrist 213E00000X NU Primary

Addresses

Primary practice location

522 Virginia St
Sikeston, MO 63801-5812

Mailing address

522 Virginia St
Sikeston, MO 63801-5812
Phone (573) 472-2202

Other identifiers 5

IdentifierTypeStateIssuer
176040OtherMOHEALTHLINK
507579407MedicaidMO
55749OtherMOGHP
9890OtherMOBLUE CROSS BLUE SHIELD MO
626035208MedicaidMO

Other names 1

  • Foot and Ankle Centers of Southeast Missouri Doing business as

National Provider Directory

National Provider Directory

Locations

35 Doctors Park
Ste 3A
Cpe Girardeau, MO 63703
Phone (573) 335-1141

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13679/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327536000000",
    "number": "1346389749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 VIRGINIA ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015812",
            "telephone_number": "573-472-2202",
            "fax_number": "573-472-3720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 VIRGINIA ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015812",
            "telephone_number": "573-472-2202",
            "fax_number": "573-472-3720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI DELTA FOOT AND ANKLE CENTERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2012-01-26",
        "status": "A",
        "authorized_official_last_name": "PROTZEL",
        "authorized_official_first_name": "HUGH",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-472-2202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": "000625",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "176040",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "507579407",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "55749",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MO",
            "identifier": "9890",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "626035208",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foot and Ankle Centers of Southeast Missouri",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sikeston, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; 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.