Fitchburg Podiatry LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

FITCHBURG PODIATRY LLC

Practice address

2960 Triverton Pike Dr Ste 107
Fitchburg, WI 53711-7516

Phone

(307) 714-2316

NPI assigned

Nov 14, 2024

Organization subpart

No

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

Authorized official

Name

Mary Elizabeth Hickner, DPMNPI 1043730625

Title

Podiatrist

Phone

(307) 714-2316

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Elizabeth Hickner

  • Podiatrist
  • Fitchburg, WI
  • NPI 1043730625
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1731542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735516800000",
    "number": "1629892674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 TRIVERTON PIKE DR STE 107",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537117516",
            "telephone_number": "307-714-2316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 TRIVERTON PIKE DR STE 107",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537117516",
            "telephone_number": "307-714-2316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FITCHBURG PODIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-14",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A",
        "authorized_official_last_name": "HICKNER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "307-714-2316",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Fitchburg Family Clinic LLC (Fitchburg Family Clinic)
• Fitchburg Family Pharmacy
• Fitchburg Family Pharmacy LLC (Fitchburg Family Pharmacy)
• Fitchburg Transit LLC
• Ashley Ann Flesch, PTA
• David Francis Florio, M.D.
• Therese M Foiles, LPN
• Forward Learning Youth and Young Adults

• Foot & Ankle Surgery Podiatrist in Fitchburg, WI
• Providers in Fitchburg, WI by specialty
• Foot & Ankle Surgery Podiatrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.