Hudson Foot Clinic, Inc.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

36-00-2719 Issued in OH

Legal business name

HUDSON FOOT CLINIC, INC.

Doing business as

Western Reserve Foot Clinic

Practice address

4495 Darrow Rd
Stow, OH 44224-1854

Phone

(330) 689-3338

Fax

(330) 689-0282

NPI assigned

Apr 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Harley Nixon, D.P.M.NPI 1679571939

Title

President

Phone

(330) 689-3338

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Western Reserve Foot Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in OH2 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.

• Kenneth H. Nixon, D.P.M.

  • Podiatrist
  • Stow, OH
  • NPI 1679571939
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240444800000",
    "number": "1619192655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4495 DARROW RD",
            "city": "STOW",
            "state": "OH",
            "postal_code": "442241854",
            "telephone_number": "330-689-3338",
            "fax_number": "330-689-0282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4495 DARROW RD",
            "city": "STOW",
            "state": "OH",
            "postal_code": "442241854",
            "telephone_number": "330-689-3338",
            "fax_number": "330-689-0282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUDSON FOOT CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2009-04-23",
        "status": "A",
        "authorized_official_last_name": "NIXON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "HARLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-689-3338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36-00-2719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2915742",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "480016282",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Western Reserve Foot Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tracey Howard, SLP
• Bonnie J Howell, MD
• Sally Ann Hu, LPN
• Yangyang Hu, CNP
• Christen Hubbard
• Shelle Mae Huff
• Corey Michael Hughes, CPST
• Joel Hughes, PH.D.
• Krista Hupe
• Mark A Iati, D.D.S.

• Podiatrist in Stow, OH
• Providers in Stow, OH by specialty
• Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2009; 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.