NPIMap

Organization Active NPI

Kentuckiana Foot & Ankle, PLLC

  • Durable Medical Equipment & Medical Supplies
  • Louisville, KY
National Provider Identifier
1770820680
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
00310 Issued in KY
Legal business name
KENTUCKIANA FOOT & ANKLE, PLLC
Practice address
7397 Jefferson Blvd
Louisville, KY 40219-6178
Phone
(502) 968-2233
NPI assigned
Jan 11, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Authorized official

Name
Syed A Khader, DPMNPI 1841272721
Title
Owner Physician
Phone
(502) 968-2233

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
Durable Medical Equipment & Medical Supplies 332B00000X 00310 KY Primary

Addresses

Primary practice location

7397 Jefferson Blvd
Louisville, KY 40219-6178

Mailing address

6801 Dixie Hwy
Ste 134
Louisville, KY 40258-3952
Phone (502) 447-4500

Other identifiers 1

IdentifierTypeStateIssuer
7100236440MedicaidKY

Other names 1

  • Kentucky Foot and Ankle, PLLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130318000312 KY DME Supplier - Physician - Podiatry 4880752443 Practice locations: Louisville, KY

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Kentuckiana Foot and Ankle PLLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7397 Jefferson Blvd
Louisville, KY 40219
Phone (502) 805-3338

Practitioners & affiliated clinicians

Practitioners 1

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": "1357862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722384000000",
    "number": "1770820680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 DIXIE HWY",
            "address_2": "STE 134",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402583952",
            "telephone_number": "502-447-4500",
            "fax_number": "502-449-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7397 JEFFERSON BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402196178",
            "telephone_number": "502-968-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKIANA FOOT & ANKLE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-11",
        "last_updated": "2024-07-31",
        "certification_date": "2022-05-03",
        "status": "A",
        "authorized_official_last_name": "KHADER",
        "authorized_official_first_name": "SYED",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "502-968-2233",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "KY",
            "license": "00310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100236440",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kentucky Foot and Ankle, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

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