NPIMap

Organization Active NPI

Foot & Ankle Associates of Siouxland, P.L.C.

  • Podiatrist
  • Sioux City, IA
National Provider Identifier
1699096537
Registry record updated Jun 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
362 Issued in IA
Legal business name
FOOT & ANKLE ASSOCIATES OF SIOUXLAND, P.L.C.
Practice address
3450 S Lakeport St
Suite B
Sioux City, IA 51106-4543
Phone
(712) 255-5048
Fax
(712) 255-5263
NPI assigned
Jun 15, 2010
Last updated
Jun 15, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2010

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

Authorized official

Name
Kathleen K Coffin
Title
Office Manager
Phone
(712) 255-5048

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 362 IA Primary

Addresses

Primary practice location

3450 S Lakeport St
Suite B
Sioux City, IA 51106-4543

Mailing address

3450 S Lakeport St
Suite B
Sioux City, IA 51106-4543
Phone (712) 255-5048

Other identifiers 1

IdentifierTypeStateIssuer
1184655MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100628000179 NE Part B Supplier - Clinic/Group Practice 4486785953 Practice locations: South Sioux City, NE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276560000000",
    "number": "1699096537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 S LAKEPORT ST",
            "address_2": "SUITE B",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511064543",
            "telephone_number": "712-255-5048",
            "fax_number": "712-255-5263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 S LAKEPORT ST",
            "address_2": "SUITE B",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511064543",
            "telephone_number": "712-255-5048",
            "fax_number": "712-255-5263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT & ANKLE ASSOCIATES OF SIOUXLAND, P.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-15",
        "last_updated": "2010-06-15",
        "status": "A",
        "authorized_official_last_name": "COFFIN",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "712-255-5048"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IA",
            "license": "362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184655",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2010; 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.