Organization Active NPI

Family Foot and Ankle Clinic LLC

  • Podiatrist
  • Wausau, WI
National Provider Identifier
1376161976
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
FAMILY FOOT AND ANKLE CLINIC LLC
Practice address
1901 Westwood Boulevard
Wausau, WI 54401
Phone
(715) 241-8100
NPI assigned
Jul 9, 2020
Organization subpart
Yes
Parent organization
FAMILY FOOT AND ANKLE CLINIC, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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

Authorized official

Name
Joel J Tikalsky, DPM
Title
President
Phone
(715) 241-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

1901 Westwood Boulevard
Wausau, WI 54401

Mailing address

5403 Normandy St
Weston, WI 54476-2217
Phone (715) 241-8100

National Provider Directory

National Provider Directory
Part of
Family Foot and Ankle Clinic LLC

Ownership & related parties

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.

NPI Registry JSON

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

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594252800000",
    "number": "1376161976",
    "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": "1901 WESTWOOD BOULEVARD",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "54401",
            "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": "2020-07-09",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "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_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.