Missouri Podiatric Surgicare LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

000689 Issued in MO

Legal business name

MISSOURI PODIATRIC SURGICARE LLC

Practice address

851 E 5TH St
Suite 228
Washington, MO 63090-3135

Phone

(636) 239-0018

NPI assigned

Apr 25, 2008

Last updated

Apr 25, 2008By 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. John M Dailey, DPM, MBA, FACFAOM

Title

President

Phone

(636) 239-0018

Specialties & licenses 2

Addresses

Tax ID family

Missouri Podiatric Surgicare LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Missouri Podiatric Surgicare LLC

  • Ambulatory Surgical Clinic/Center
  • Washington, MO
  • NPI 1184804197
  NPD tax ID

Locations

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1447425988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 E 5TH ST",
            "address_2": "SUITE 228",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630903135",
            "telephone_number": "636-239-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 E 5TH ST",
            "address_2": "SUITE 228",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630903135",
            "telephone_number": "636-239-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI PODIATRIC SURGICARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-25",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "DAILEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "636-239-0018",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM, MBA, FACFAOM"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MO",
            "license": "000689",
            "primary": true
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "MO",
            "license": "000689",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Missouri CVS Pharmacy LLC (CVS Pharmacy #17330)
• Missouri CVS Pharmacy, L.L.C. (CVS Pharmacy #18082)
• Missouri Foot and Ankle Institute
• Missouri Occupational Medicine
• Missouri Podiatric Surgicare LLC
• Missouri Valley Anesthesia, PC
• Kersten Ann Mitchell
• Mobility Scooters of Washington LLC
• Ann E Mohart, M.D.
• John M Mohart, M.D.

• Clinic/Center in Washington, MO
• Providers in Washington, MO by specialty
• Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; 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.