Bluegrass Foot and Ankle Care, PLLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

00274 Issued in KY

Legal business name

BLUEGRASS FOOT AND ANKLE CARE, PLLC

Practice address

326 Highland Park Dr
Richmond, KY 40475-3487

Phone

(859) 623-3550

NPI assigned

Mar 7, 2007

Last updated

Sep 20, 2019By 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. Randall W. Hall, D.P.M.NPI 1215935671

Title

Business Owner

Phone

(859) 623-3550

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in KY2 enrollments

Enrollment records 2

Tax ID family

Bluegrass Foot and Ankle Care2 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.

• Bluegrass Foot and Ankle Care

  • Customized Equipment (DME)
  • Richmond, KY
  • NPI 1972783157
  NPD tax ID

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.

• Randall Wayne Hall, D.P.M.

  • Podiatrist
  • Richmond, KY
  • NPI 1215935671
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568937600000",
    "number": "1598896334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 HIGHLAND PARK DR",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404753487",
            "telephone_number": "859-623-3550",
            "fax_number": "859-623-3393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 HIGHLAND PARK DR",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404753487",
            "telephone_number": "859-623-3550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "322 Highland Park Dr",
            "address_2": "Suite 9",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "KY",
            "postal_code": "404753487",
            "country_code": "US",
            "telephone_number": "859-623-3550",
            "fax_number": "859-623-3393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLUEGRASS FOOT AND ANKLE CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2019-09-20",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "859-623-3550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "KY",
            "license": "00274",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "KY",
            "license": "00274",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90011214",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100051420",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000330835",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyler Blevins
• Bluegrass Cardiology PSC
• Bluegrass Counseling and Psychotherapy, LLC
• Bluegrass Foot and Ankle Care
• Bluegrass Foot and Ankle Care PLLC
• Bluegrass Hearing Clinic, LLC
• Bluegrass House Calls PLLC
• Bluegrass Long Term Care
• Bluegrass Medical & Public Transportation
• Bluegrass Pediatric Dentistry

• Podiatrist in Richmond, KY
• Providers in Richmond, KY by specialty
• Podiatrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; 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.