Organization Active NPI

Feet First Podiatry LLC

  • Foot & Ankle Surgery Podiatrist
  • Saint Peters, MO
National Provider Identifier
1700917960
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
2001015897 Issued in MO
Legal business name
FEET FIRST PODIATRY LLC
Practice address
2046 Queensbrooke Blvd Ste 100
Saint Peters, MO 63376-7881
Phone
(636) 477-7300
Fax
(636) 922-0884
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Authorized official

Name
Dr. Daniel Adamovsky, DPMNPI 1174511521
Title
President
Phone
(636) 477-7300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 2001015897 MO Primary

Addresses

Primary practice location

2046 Queensbrooke Blvd Ste 100
Saint Peters, MO 63376-7881

Mailing address

2046 Queensbrooke Blvd Ste 100
Saint Peters, MO 63376-7881
Phone (636) 477-7300

Other practice location 1

200 Healthcare Drive
Specialty Clinic
Greenville, IL 62246
Phone (636) 477-7300

Other practice location 2

1021 Wentzville Pkwy
Wentzville, MO 63385-3437
Phone (633) 477-7300

Other identifiers 1

IdentifierTypeStateIssuer
504595208MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20050125000180 MO Part B Supplier - Clinic/Group Practice 8527018993 Receives reassigned benefits from 3 practitioners
Practice locations: Saint Peters, MO; St Charles, MO; Wentzville, MO
O20060310000041 IL Part B Supplier - Clinic/Group Practice 8527018993 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
Practice locations: Breese, IL; Greenville, IL
O20100930085755 MO DME Supplier - Physician - Podiatry 8527018993 Practice locations: Saint Peters, MO

National Provider Directory

National Provider Directory

Locations

10441 International Plaza Dr
Saint Ann, MO 63074
Phone (314) 423-0600

2318 Highway 94 South Outer Rd
Saint Charles, MO 63303
Phone (636) 477-7300

2046 Queensbrooke Blvd
Ste 100
Saint Peters, MO 63376
Phone (636) 477-7300

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621382400000",
    "number": "1700917960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2046 QUEENSBROOKE BLVD STE 100",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633767881",
            "telephone_number": "636-477-7300",
            "fax_number": "636-922-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2046 QUEENSBROOKE BLVD STE 100",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633767881",
            "telephone_number": "636-477-7300",
            "fax_number": "636-922-0884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Healthcare Drive",
            "address_2": "Specialty Clinic",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "IL",
            "postal_code": "62246",
            "country_code": "US",
            "telephone_number": "636-477-7300",
            "fax_number": "636-922-0884",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1021 Wentzville Pkwy",
            "address_purpose": "LOCATION",
            "city": "Wentzville",
            "state": "MO",
            "postal_code": "633853437",
            "country_code": "US",
            "telephone_number": "633-477-7300",
            "fax_number": "636-922-0884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FEET FIRST PODIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A",
        "authorized_official_last_name": "ADAMOVSKY",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "636-477-7300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "2001015897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "504595208",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; 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.