NPIMap

Organization Active NPI

Nettesheim Family Foot Care, P.C.

  • Foot & Ankle Surgery Podiatrist
  • Saint Louis, MO
National Provider Identifier
1861691883
Registry record updated May 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
000531 Issued in MO
Legal business name
NETTESHEIM FAMILY FOOT CARE, P.C.
Practice address
4305 Butler Hill Rd
Suite B
Saint Louis, MO 63128-3718
Phone
(314) 849-9009
Fax
(314) 849-9004
NPI assigned
Jul 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2015

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

Authorized official

Name
Dr. Kevin A Nettesheim, D.P.M.NPI 1366445314
Title
Owner
Phone
(314) 849-9009

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
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 000531 MO Primary

Addresses

Primary practice location

4305 Butler Hill Rd
Suite B
Saint Louis, MO 63128-3718

Mailing address

4305 Butler Hill Rd Ste B
Saint Louis, MO 63128-3718
Phone (314) 849-9009

Other identifiers 5

IdentifierTypeStateIssuer
990001711OtherMOMEDICARE ID
104946-003OtherMOBLUECROSS BLUESHIED OF MI
102788OtherGROUP HEALTH PLAN
107843OtherHEALTHLINK
308054006MedicaidMO

National Provider Directory

National Provider Directory

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": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431043200000",
    "number": "1861691883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 BUTLER HILL RD STE B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283718",
            "telephone_number": "314-849-9009",
            "fax_number": "314-849-9004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 BUTLER HILL RD",
            "address_2": "SUITE B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283718",
            "telephone_number": "314-849-9009",
            "fax_number": "314-849-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NETTESHEIM FAMILY FOOT CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-11",
        "last_updated": "2015-05-08",
        "status": "A",
        "authorized_official_last_name": "NETTESHEIM",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-849-9009",
        "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": "MO",
            "license": "000531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "990001711",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIED OF MI",
            "identifier": "104946-003",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH PLAN",
            "identifier": "102788",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "107843",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "308054006",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2015; 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.