Oldham County Foot & Ankle PLLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

OLDHAM COUNTY FOOT & ANKLE PLLC

Practice address

6400 Westwind Way
Suite B
Crestwood, KY 40014-6773

Phone

(502) 276-9999

NPI assigned

Mar 18, 2014

Last updated

Sep 8, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jasen T Pedersen, DPMNPI 1114182326

Title

Owner

Phone

(502) 276-9999

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY2 enrollments

Enrollment records 2

Locations

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.

• Jasen Thomas Pedersen, DPM

  • Foot & Ankle Surgery Podiatrist
  • Crestwood, KY
  • NPI 1114182326

  Multi-Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1395100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599523200000",
    "number": "1376969105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 WESTWIND WAY",
            "address_2": "SUITE B",
            "city": "CRESTWOOD",
            "state": "KY",
            "postal_code": "400146773",
            "telephone_number": "502-276-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 WESTWIND WAY",
            "address_2": "SUITE B",
            "city": "CRESTWOOD",
            "state": "KY",
            "postal_code": "400146773",
            "telephone_number": "502-276-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLDHAM COUNTY FOOT & ANKLE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-18",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A",
        "authorized_official_last_name": "PEDERSEN",
        "authorized_official_first_name": "JASEN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-276-9999",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "7100571860",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100580750",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danny Nguyen
• Tu K Nguyen, PHARMD
• Tammy Nischan
• Alison Claire Oesterritter
• Oldham County Assessment & Psychological Service
• Mary E Olson, MS
• On Track Speech Therapy, LLC
• On-Site Enterprises of Oldham,LLC
• Osting Psychiatry & Wellness, PLLC
• Rachel Jaclyn Otis, MS, RDN, LD/N

• Foot & Ankle Surgery Podiatrist in Crestwood, KY
• Providers in Crestwood, KY by specialty
• Foot & Ankle Surgery Podiatrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare 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.