White Bear Foot and Ankle Clinic, Inc.

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

License

923 Issued in MN

Legal business name

WHITE BEAR FOOT AND ANKLE CLINIC, INC.

Practice address

4653 White Bear Pkwy
White Bear Lake, MN 55110-3300

Phone

(651) 426-3995

Fax

(651) 426-5626

NPI assigned

Nov 10, 2014

Last updated

Nov 10, 2014By 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. Christopher Phillips, DPMNPI 1891081386

Title

Doctor/Owner

Phone

(651) 426-3995

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

White Bear Foot and Ankle Clinic Inc2 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.

• White Bear Foot and Ankle Clinic Inc

  • Foot & Ankle Surgery Podiatrist
  • White Bear Lake, MN
  • NPI 1467879684
  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.

• Christopher M Phillips, DPM.

  • Foot & Ankle Surgery Podiatrist
  • White Bear Lake, MN
  • NPI 1891081386
  NPD (past) Authorized official

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

{
    "created_epoch": "1415577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415577600000",
    "number": "1659777290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4653 WHITE BEAR PKWY",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103300",
            "telephone_number": "651-426-3995",
            "fax_number": "651-426-5626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4653 WHITE BEAR PKWY",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103300",
            "telephone_number": "651-426-3995",
            "fax_number": "651-426-5626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE BEAR FOOT AND ANKLE CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-10",
        "last_updated": "2014-11-10",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "651-426-3995",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "MN",
            "license": "923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "472603200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Westerheide, LICSW
• Lea Wetzell, L.N, C.N.S
• White Bear Area Senior Progam Isd 624
• White Bear Dentists, PC (White Bear Dentists)
• White Bear Foot and Ankle Clinic Inc
• White Bear Foot Clinic Inc
• White Bear Health Mart Pharmacy LLC (White Bear Health Mart)
• White Bear Lake Orthodontics
• White Bear Smiles, P.a.
• Meghan Wicklund, PHARMD

• Podiatric Clinic/Center in White Bear Lake, MN
• Providers in White Bear Lake, MN by specialty
• Podiatric Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; 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.