Foot Health Center of Mid-Missouri LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

MO000667 Issued in MO

Legal business name

FOOT HEALTH CENTER OF MID-MISSOURI LLC

Practice address

3207 W Truman Blvd
Jefferson City, MO 65109-0892

Phone

(573) 659-2376

Fax

(573) 893-3342

NPI assigned

Jul 26, 2006

Last updated

Jun 21, 2018By 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

Dr. David Stephen Carron, D.P.M.NPI 1174569883

Title

Podiatrist

Phone

(573) 659-2376

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MO2 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.

• David Stephen Carron, D.P.M

  • Podiatrist
  • Jefferson City, MO
  • NPI 1174569883
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1427071844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3207 W TRUMAN BLVD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651090892",
            "telephone_number": "573-659-2376",
            "fax_number": "573-893-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3207 W TRUMAN BLVD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651090892",
            "telephone_number": "573-659-2376",
            "fax_number": "573-893-3342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT HEALTH CENTER OF MID-MISSOURI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "CARRON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "573-659-2376",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MO",
            "license": "MO000667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4565615",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "248520",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "25894",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF1787",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Focused Health and Wellness Inc
• Brooklynne Elizabeth Fogle, PA
• Lora Bias Folz, M.D.
• Thomas J. Folz, M.D.
• Deidra Leann Fooks, PTA
• David Foote, PH.D.
• Timothy Foreman, MD
• Formanek DDS LLC
• Randy Forsee, LPN
• Beatriz Alejandra Fortaleza, ANP

• Podiatrist in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Podiatrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.