Organization Active NPI

Advanced Foot & Ankle PLLC

  • Podiatric Clinic/Center
  • Louisville, KY
National Provider Identifier
1780776567
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
Legal business name
ADVANCED FOOT & ANKLE PLLC
Practice address
3430 Newburg Rd
Ste 153
Louisville, KY 40218
Phone
(502) 459-8127
Fax
(502) 459-8620
NPI assigned
Sep 29, 2006
Last updated
Oct 15, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Authorized official

Name
Mr. John T Sanders, DPMNPI 1588743793
Title
Owner
Phone
(502) 459-8127

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
Podiatric Clinic/Center 261QP1100X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

3430 Newburg Rd
Ste 153
Louisville, KY 40218

Mailing address

3430 Newburg Rd
Ste 153
Louisville, KY 40218
Phone (502) 459-8127

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050823000470 KY Part B Supplier - Clinic/Group Practice 4587695200 Receives reassigned benefits from 2 practitioners
Practice locations: Louisville, KY
O20100930033079 KY DME Supplier - Physician - Podiatry 4587695200 Practice locations: Louisville, KY

National Provider Directory

National Provider Directory

Locations

10112 Taylorsville Rd
Louisville, KY 40299
Phone (502) 267-1411

3430 Newburg Rd
Ste 153
Louisville, KY 40218
Phone (502) 459-8127

Practitioners & affiliated clinicians

Practitioners 4

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": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602720000000",
    "number": "1780776567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3430 NEWBURG RD",
            "address_2": "STE 153",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40218",
            "telephone_number": "502-459-8127",
            "fax_number": "502-459-8620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 NEWBURG RD",
            "address_2": "STE 153",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40218",
            "telephone_number": "502-459-8127",
            "fax_number": "502-459-8620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED FOOT & ANKLE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-459-8127",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 15, 2020; 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.