Foot and Ankle Clinic, PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

00505 Issued in IA

Legal business name

FOOT AND ANKLE CLINIC, PC

Practice address

810 N 22ND St
Blair, NE 68008-1128

Phone

(402) 426-1239

Fax

(402) 426-1191

NPI assigned

Jan 28, 2011

Organization subpart

No

Name

Dr. Kham Vay Ung, DPM

Title

President/Owner

Phone

(712) 255-0502

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 14, 2016.

{
    "created_epoch": "1296172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465862400000",
    "number": "1922304682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 PIERCE ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511051246",
            "telephone_number": "712-255-0502",
            "fax_number": "712-258-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 N 22ND ST",
            "city": "BLAIR",
            "state": "NE",
            "postal_code": "680081128",
            "telephone_number": "402-426-1239",
            "fax_number": "402-426-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-28",
        "last_updated": "2016-06-14",
        "status": "A",
        "authorized_official_last_name": "UNG",
        "authorized_official_first_name": "KHAM",
        "authorized_official_middle_name": "VAY",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "712-255-0502",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IA",
            "license": "00505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0476317",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6800690",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6800700",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6800454",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alicia Ferris
• John Ryan D Fetters
• Gary D Finn, O.D.
• Janice C Fitchhorn
• Michelle Lee Flores, MS/CCC/SLP
• Andrea Fritz
• Leisha Frum
• Janessa Jean Jade Gallegos
• Antonia Gallo, MOTR/L
• Erin Gantz

• All providers in Blair, NE
• Foot & Ankle Surgery Podiatrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; 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.