NPIMap

Organization Active NPI

Maplewood Podiatry Clinic

  • Podiatrist
  • St. Anthony, MN
National Provider Identifier
1497813190
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
MAPLEWOOD PODIATRY CLINIC
Practice address
2600 39TH Avenue NE
Suite 250
St. Anthony, MN 55421
Phone
(612) 788-7274
Fax
(612) 788-3408
NPI assigned
Dec 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ross Nelson, DPM
Title
Owner
Phone
(651) 439-5278

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

2600 39TH Avenue NE
Suite 250
St. Anthony, MN 55421

Mailing address

1940 Greeley St S
Suite 122
Stillwater, MN 55082-5097
Phone (651) 439-5278

Other names 1

  • Midwest Foot & Ankle Specialists, LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Maplewood Podiatry Clinic2 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.

Locations

2600 39th Ave NE
Ste 250
Saint Anthony, MN 55421
Phone (612) 788-7274

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497813190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 GREELEY ST S",
            "address_2": "SUITE 122",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550825097",
            "telephone_number": "651-439-5278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 39TH AVENUE NE",
            "address_2": "SUITE 250",
            "city": "ST. ANTHONY",
            "state": "MN",
            "postal_code": "55421",
            "telephone_number": "612-788-7274",
            "fax_number": "612-788-3408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLEWOOD PODIATRY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "ROSS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-439-5278",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Foot & Ankle Specialists, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St. Anthony, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.