NPIMap

Organization Active NPI

Foot & Ankle Specialists of West Michigan P L L C

  • Durable Medical Equipment & Medical Supplies
  • Grand Rapids, MI
National Provider Identifier
1417155508
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
WD000997 Issued in MI
Legal business name
FOOT & ANKLE SPECIALISTS OF WEST MICHIGAN P L L C
Practice address
1195 Wilson NW
Grand Rapids, MI 49534-6404
Phone
(616) 453-8277
Fax
(616) 453-2002
NPI assigned
Jul 10, 2007
Organization subpart
Yes
Parent organization
FOOT & ANKLE SPECIALISTS OF WEST MICHIGAN P L L CAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Authorized official

Name
Lowell Weil Jr., DPM
Title
Executive Chairman
Phone
(847) 390-7666

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X OM71140 MI
Durable Medical Equipment & Medical Supplies 332B00000X WD000997 MI Primary

Addresses

Primary practice location

1195 Wilson NW
Grand Rapids, MI 49534-6404

Mailing address

2144 E Paris Ave SE Ste 100
Grand Rapids, MI 49546-6117
Phone (616) 281-0666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930003368 MI DME Supplier - Physician - Podiatry 2769475441 Practice locations: Grand Rapids, MI

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Foot and Ankle Spec of10 organizations share this tax ID, including this one
Part of
Foot and Ankle Spec of

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

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.

Practitioners & affiliated clinicians

Practitioners 1

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": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687392000000",
    "number": "1417155508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2144 E PARIS AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466117",
            "telephone_number": "616-281-0666",
            "fax_number": "616-281-0752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1195 WILSON NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495346404",
            "telephone_number": "616-453-8277",
            "fax_number": "616-453-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT & ANKLE SPECIALISTS OF WEST MICHIGAN P L L C",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOOT & ANKLE SPECIALISTS OF WEST MICHIGAN P L L C",
        "enumeration_date": "2007-07-10",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A",
        "authorized_official_last_name": "WEIL",
        "authorized_official_first_name": "LOWELL",
        "authorized_official_title_or_position": "EXECUTIVE CHAIRMAN",
        "authorized_official_telephone_number": "847-390-7666",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "OM71140",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": "WD000997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.