Organization Active NPI

Valarie Ikerd DPM LLC

  • Podiatrist
  • Joplin, MO
National Provider Identifier
1962652834
Registry record updated Feb 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
VALARIE IKERD DPM LLC
Practice address
1501 E 20TH St
Joplin, MO 64804-0928
Phone
(417) 659-9395
Fax
(417) 659-9695
NPI assigned
Sep 26, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2015

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

Authorized official

Name
Valarie Ikerd, DPM
Title
Owner
Phone
(417) 659-9395

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

1501 E 20TH St
Joplin, MO 64804-0928

Mailing address

1501 E 20TH St
Joplin, MO 64804-0928
Phone (417) 659-9395

Other identifiers 2

IdentifierTypeStateIssuer
112612OtherMOBCBS
1962652834MedicaidMO

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424736000000",
    "number": "1962652834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 E 20TH ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648040928",
            "telephone_number": "417-659-9395",
            "fax_number": "417-659-9695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 E 20TH ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648040928",
            "telephone_number": "417-659-9395",
            "fax_number": "417-659-9695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALARIE IKERD DPM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-26",
        "last_updated": "2015-02-24",
        "status": "A",
        "authorized_official_last_name": "IKERD",
        "authorized_official_first_name": "VALARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-659-9395",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "112612",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962652834",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.