Organization Active NPI

Foot and Ankle Professional Centers of Iowa, PC

  • Podiatrist
  • Ottumwa, IA
National Provider Identifier
1710212204
Registry record updated May 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
00582 Issued in IA
Legal business name
FOOT AND ANKLE PROFESSIONAL CENTERS OF IOWA, PC
Practice address
520 N Sheridan Ave
Ottumwa, IA 52501-4228
Phone
(641) 683-7901
Fax
(641) 682-1158
NPI assigned
Oct 16, 2009
Last updated
May 24, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2011

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

Authorized official

Name
Dr. Bruce Fridinger, D.P.M.NPI 1013998145
Title
Owner
Phone
(641) 683-7901

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
Podiatrist 213E00000X 00582 IA Primary

Addresses

Primary practice location

520 N Sheridan Ave
Ottumwa, IA 52501-4228

Mailing address

520 N Sheridan Ave
Ottumwa, IA 52501-4228
Phone (641) 683-7901

Other identifiers 1

IdentifierTypeStateIssuer
3115741MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101216000876 IA Part B Supplier - Clinic/Group Practice 4688864960 Receives reassigned benefits from 1 practitioner
Practice locations: Ottumwa, IA

National Provider Directory

National Provider Directory

Locations

520 N Sheridan Ave
Ottumwa, IA 52501
Phone (641) 682-7565

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1255651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306195200000",
    "number": "1710212204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N SHERIDAN AVE",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525014228",
            "telephone_number": "641-683-7901",
            "fax_number": "641-682-1158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N SHERIDAN AVE",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525014228",
            "telephone_number": "641-683-7901",
            "fax_number": "641-682-1158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE PROFESSIONAL CENTERS OF IOWA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-16",
        "last_updated": "2011-05-24",
        "status": "A",
        "authorized_official_last_name": "FRIDINGER",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "641-683-7901",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IA",
            "license": "00582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3115741",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottumwa, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2011; 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.