Louisiana Foot and Ankle Specialists LLC

Key facts

NPI: 1376964627
Entity type: Organization (NPI type 2)
Primary specialty: Foot & Ankle Surgery Podiatrist 213ES0103X
License: 200062 (LA)
Legal business name: LOUISIANA FOOT AND ANKLE SPECIALISTS LLC
Practice address: 212 W McNeese St
Lake Charles, LA 70605-5639
Phone: (337) 474-2233
NPI assigned: Jan 3, 2014
Organization subpart: No

Authorized official

Name: Dr. Daniel Thomas Hall IV, DPM NPI 1891124665
Title: Member/Owner
Phone: (812) 483-7886

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 3

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

Daniel Thomas Hall IV, DPM Foot & Ankle Surgery Podiatrist · Lake Charles, LA · NPI 1891124665

Medicare reassignment Care Compare group NPD Authorized official LA · PRIMARY PODIATRIC MEDICINE
Mallory Michelle Przybylski, DPM Foot & Ankle Surgery Podiatrist · Lake Charles, LA · NPI 1437449915

Medicare reassignment Care Compare group NPD FOOT & ANKLE SURGERY · LA
Charlotte D Vang, DPM Podiatrist · Merced, CA · NPI 1700867785

NPD (past) PODIATRIST

Medicare participation

Medicare fee-for-service enrollment: Enrolled (2 enrollments) in LA

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20140619001570	LA	Part B Supplier - Clinic/Group Practice	5799909461	Receives reassigned benefits from 2 practitioners Practice locations: Lake Charles, LA
O20190220000112	LA	DME Supplier - Physician - Podiatry	5799909461	Practice locations: Lake Charles, LA

National Provider Directory

Interoperability endpoints

FHIR API: https://api.platform.athenahealth.com/10228/brand/1/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Foot & Ankle Surgery Podiatrist Group: 193400000X SINGLE SPECIALTY GROUP	213ES0103X	200062	LA	Yes

Addresses

Primary practice location

212 W McNeese St
Lake Charles, LA 70605-5639

Mailing address

212 W McNeese St
Lake Charles, LA 70605-5639
Phone (337) 474-2233

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 11, 2014.

{
    "created_epoch": "1388707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405036800000",
    "number": "1376964627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 W MCNEESE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055639",
            "telephone_number": "337-474-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 W MCNEESE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055639",
            "telephone_number": "337-474-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISIANA FOOT AND ANKLE SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-03",
        "last_updated": "2014-07-11",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "MEMBER/OWNER",
        "authorized_official_telephone_number": "812-483-7886",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "LA",
            "license": "200062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

All providers in Lake Charles, LA · Foot & Ankle Surgery Podiatrist in Louisiana

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2014. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.