Organization Active NPI

Indianola Foot and Ankle Clinic PLLC

  • Podiatrist
  • Indianola, IA
National Provider Identifier
1750099867
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
INDIANOLA FOOT AND ANKLE CLINIC PLLC
Practice address
1517 N 1St St
Indianola, IA 50125-3703
Phone
(515) 666-1151
Fax
(515) 461-9995
NPI assigned
Nov 8, 2022
Last updated
Jan 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Authorized official

Name
Randy J Metzger, DPMNPI 1568776334
Title
Owner
Phone
(515) 343-4180

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 Primary

Addresses

Primary practice location

1517 N 1St St
Indianola, IA 50125-3703

Mailing address

1517 N 1St St
Indianola, IA 50125-3703
Phone (515) 666-1151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20221208001530 IA Part B Supplier - Clinic/Group Practice 1557730868 Receives reassigned benefits from 1 practitioner
Practice locations: Indianola, IA
O20230315000945 IA DME Supplier - Physician - Podiatry 1557730868 Practice locations: Indianola, IA

National Provider Directory

National Provider Directory

Locations

1517 N 1st St
Indianola, IA 50125
Phone (515) 666-1222

Practitioners & affiliated clinicians

Practitioners 3

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": "1667865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1750099867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1517 N 1ST ST",
            "city": "INDIANOLA",
            "state": "IA",
            "postal_code": "501253703",
            "telephone_number": "515-666-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 N 1ST ST",
            "city": "INDIANOLA",
            "state": "IA",
            "postal_code": "501253703",
            "telephone_number": "515-666-1151",
            "fax_number": "515-461-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANOLA FOOT AND ANKLE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-08",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A",
        "authorized_official_last_name": "METZGER",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-343-4180",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianola, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; 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.