Active NPI
Swfac PLC
Doing business as Southwest Foot and Ankle Center PLC
- Podiatrist
- Council Bluffs, IA
National Provider Identifier
1902018112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- Legal business name
- SWFAC PLC
- Doing business as
- Southwest Foot and Ankle Center PLC
- Practice address
- 103 North Ave
Council Bluffs, IA 51503 - Phone
- (712) 322-5800
- Fax
- (712) 322-8172
- NPI assigned
- May 3, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Andrew C Stanislav, DPM
- Title
- Owner
- Phone
- (712) 623-5178
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | Primary |
Addresses
Primary practice location
103 North Ave
Council Bluffs, IA 51503
Mailing address
502 E Reed St
Red Oak, IA 51566
Phone (712) 623-5178
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0429761 | Medicaid | IA |
Other names 1
- Southwest Foot and Ankle Center PLC
National Provider Directory
National Provider Directory- Tax ID family
- Southwest Foot and Ankle Center
Other organizations with this tax ID 6
Organizations that report the same tax identification number in the National Provider Directory.
Locations
502 E Reed St
Red Oak, IA 51566
Phone (712) 623-5178
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1902018112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "502 E REED ST",
"city": "RED OAK",
"state": "IA",
"postal_code": "51566",
"telephone_number": "712-623-5178",
"fax_number": "712-623-2703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 NORTH AVE",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "51503",
"telephone_number": "712-322-5800",
"fax_number": "712-322-8172"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SWFAC PLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-03",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "STANISLAV",
"authorized_official_first_name": "ANDREW",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "712-623-5178",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Podiatrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0429761",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Southwest Foot and Ankle Center PLC",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Council Bluffs, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.