NPIMap

Organization Active NPI

Foot and Ankle Clinic of West Michigan,PC

  • Foot & Ankle Surgery Podiatrist
  • Ludington, MI
National Provider Identifier
1356441695
Registry record updated Jul 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
5901001496 Issued in MI
Legal business name
FOOT AND ANKLE CLINIC OF WEST MICHIGAN,PC
Practice address
333 N Jebavy Dr
Ludington, MI 49431-1923
Phone
(231) 843-2690
Fax
(231) 843-4338
NPI assigned
Sep 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2008

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

Authorized official

Name
Dr. Alan L Mast, DPM
Title
Owner
Phone
(231) 843-2690

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 5901001496 MI Primary

Addresses

Primary practice location

333 N Jebavy Dr
Ludington, MI 49431-1923

Mailing address

333 N Jebavy Dr
Ludington, MI 49431-1923
Phone (231) 843-2690

Other identifiers 2

IdentifierTypeStateIssuer
2584722MedicaidMI
0E36017OtherMIMEDICARE ID-TYPE UNSPECIF

National Provider Directory

National Provider Directory

Locations

611 E Main St
Hart, MI 49420
Phone (231) 873-5478

1 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2591

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216857600000",
    "number": "1356441695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N JEBAVY DR",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311923",
            "telephone_number": "231-843-2690",
            "fax_number": "231-843-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N JEBAVY DR",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311923",
            "telephone_number": "231-843-2690",
            "fax_number": "231-843-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE CLINIC OF WEST MICHIGAN,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2008-07-24",
        "status": "A",
        "authorized_official_last_name": "MAST",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-843-2690",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901001496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2584722",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-TYPE UNSPECIF",
            "identifier": "0E36017",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ludington, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; 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.