Family Foot and Ankle Clinic LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

FAMILY FOOT AND ANKLE CLINIC LLC

Practice address

1439 Churchill St Ste 202
Waupaca, WI 54981-2089

Phone

(715) 241-8100

NPI assigned

Jul 8, 2020

Organization subpart

Yes

Parent organization

FAMILY FOOT AND ANKLE CLINIC, LLCAs reported in NPPES

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

Authorized official

Name

Dr. Joel J Tikalsky, DPM

Title

President

Phone

(715) 241-8100

Specialties & licenses 1

Addresses

Part of

Family Foot and Ankle Clinic LLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Family Foot and Ankle Clinic LLC

  • Podiatrist
  • Weston, WI
  • NPI 1659439321
  NPPES parent name

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594166400000",
    "number": "1376161240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5403 NORMANDY ST",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544762217",
            "telephone_number": "715-241-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1439 CHURCHILL ST STE 202",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549812089",
            "telephone_number": "715-241-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY FOOT AND ANKLE CLINIC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY FOOT AND ANKLE CLINIC, LLC",
        "enumeration_date": "2020-07-08",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A",
        "authorized_official_last_name": "TIKALSKY",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "715-241-8100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Evers, PHARMD
• Trisha Ann Everson, PA-C
• Daniel R Everts, OD
• Jacqueline Ann Everts
• Extendicare Homes, Inc.
• Chelsea Fay, APNP
• Deborah L Ferguson, NP
• James Michael Fico, PHD
• Melissa A Flease, RDH
• Tammy M Flynn, APNP,PMHNP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; 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.