Wisconsin Visiting Podiatry

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

WISCONSIN VISITING PODIATRY

Practice address

28606 Sandpiper TRL
Waterford, WI 53185-1733

Phone

(224) 234-7304

NPI assigned

Nov 4, 2015

Last updated

Jan 27, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Laura Carter

Title

Credentialing Manager

Phone

(262) 444-3132

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Jeffrey A Fischer, D.P.M.

  • Podiatrist
  • Milwaukee, WI
  • NPI 1346251303
  NPD (past)
• Robert Cooper, MD

  • Internal Medicine Physician
  • Crosby, MN
  • NPI 1356396394
  NPD (past)

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643241600000",
    "number": "1790158368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 187",
            "city": "WATERFORD",
            "state": "WI",
            "postal_code": "531850187",
            "telephone_number": "262-444-3132",
            "fax_number": "877-636-1498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28606 SANDPIPER TRL",
            "city": "WATERFORD",
            "state": "WI",
            "postal_code": "531851733",
            "telephone_number": "224-234-7304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN VISITING PODIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-04",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "262-444-3132"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43221600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Waterford Place
• Waterford Union High School
• Beth A Weidman, APNP
• Karen Jean Wilks
• Jana L Williams
• Mark Wood, RPH
• Johanna Rachel Young, PTA
• Sharon Zach

• Foot & Ankle Surgery Podiatrist in Waterford, WI
• Providers in Waterford, WI by specialty
• Foot & Ankle Surgery Podiatrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.