Advanced Foot and Ankle Academy

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

ADVANCED FOOT AND ANKLE ACADEMY

Practice address

5317 Itaska St Unit 2F
Saint Louis, MO 63109-2921

Phone

(646) 251-8364

NPI assigned

Apr 26, 2023

Last updated

Jun 28, 2023By 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. Timur Davydov, DPMNPI 1518455187

Title

Owner

Phone

(646) 251-8364

Specialties & licenses 1

Addresses

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.

• Timur Davydov, DPM

  • Foot & Ankle Surgery Podiatrist
  • Belleville, IL
  • NPI 1518455187
  Authorized official Same address or phone

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687910400000",
    "number": "1669160859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5317 ITASKA ST UNIT 2F",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631092921",
            "telephone_number": "646-251-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5317 ITASKA ST UNIT 2F",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631092921",
            "telephone_number": "646-251-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED FOOT AND ANKLE ACADEMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-26",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A",
        "authorized_official_last_name": "DAVYDOV",
        "authorized_official_first_name": "TIMUR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "646-251-8364",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Foot & Ankle Surgery Podiatrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.