Intermountain Foot & Ankle Assoc P.C

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

517 Issued in CO

Legal business name

INTERMOUNTAIN FOOT & ANKLE ASSOC P.C

Practice address

9348 Grand Cordera Pkwy Ste 210
Colorado Springs, CO 80924-7002

Phone

(719) 594-9920

Fax

(719) 598-6212

NPI assigned

Dec 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kerry Elizebeth Berg, D.P.M.

Title

Owner/Physician

Phone

(719) 594-9920

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1780866459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9348 GRAND CORDERA",
            "address_2": "PKWY 210",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809244062",
            "telephone_number": "719-594-9920",
            "fax_number": "719-598-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9348 GRAND CORDERA PKWY STE 210",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809247002",
            "telephone_number": "719-594-9920",
            "fax_number": "719-598-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTAIN FOOT & ANKLE ASSOC P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "KERRY",
        "authorized_official_middle_name": "ELIZEBETH",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "719-594-9920",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CO",
            "license": "517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CD1850",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01005180",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04532339",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Providers in Colorado Springs, CO by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.