NPIMap

Organization Active NPI

Kentuckiana Foot & Ankle, PLLC

  • Durable Medical Equipment & Medical Supplies
  • Bowling Green, KY
National Provider Identifier
1780472373
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
KENTUCKIANA FOOT & ANKLE, PLLC
Practice address
1938 Lyda Ave
Bowling Green, KY 42104-3326
Phone
(270) 796-6160
NPI assigned
Apr 25, 2025
Last updated
May 21, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
KENTUCKIANA FOOT & ANKLE, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Authorized official

Name
Syed Abdul KhaderNPI 1841272721
Title
Owner
Phone
(502) 533-9071

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X NU
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

1938 Lyda Ave
Bowling Green, KY 42104-3326

Mailing address

6801 Dixie Hwy Ste 134
Louisville, KY 40258-3952
Phone (502) 805-3338

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250514001855 KY DME Supplier - Physician - Podiatry 4880752443 Practice locations: Bowling Green, 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 PLLC11 organizations share this tax ID, including this one
Part of
Kentuckiana Foot PLLC

Other organizations with this tax ID 10

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

Locations

1263 Hospital Dr NW
Ste 120
Corydon, IN 47112
Phone (812) 738-8730

3045 Ring Rd
Elizabethtown, KY 42701
Phone (270) 737-3338

1019 Commerce Pkwy
Lagrange, KY 40031
Phone (502) 225-9098

4420 Dixie Hwy
Ste 130
Louisville, KY 40216
Phone (502) 805-3338

8017 Bardstown Rd
Ste 106
Louisville, KY 40291
Phone (502) 239-6600

Practitioners & affiliated clinicians

Practitioners 28

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 28

NPI Registry JSON

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

{
    "created_epoch": "1745539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779321600000",
    "number": "1780472373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 DIXIE HWY STE 134",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402583952",
            "telephone_number": "502-805-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1938 LYDA AVE",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043326",
            "telephone_number": "270-796-6160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKIANA FOOT & ANKLE, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KENTUCKIANA FOOT & ANKLE, PLLC",
        "enumeration_date": "2025-04-25",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A",
        "authorized_official_last_name": "KHADER",
        "authorized_official_first_name": "SYED",
        "authorized_official_middle_name": "ABDUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-533-9071"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; 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.