Organization Active NPI

Midwest Foot and Wound Care Center LLC

  • Podiatrist
  • Fond Du Lac, WI
National Provider Identifier
1972856169
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
801-25 Issued in WI
Legal business name
MIDWEST FOOT AND WOUND CARE CENTER LLC
Practice address
355 N Peters Ave Ste 3
Fond Du Lac, WI 54935-8115
Phone
(920) 539-5400
Fax
(920) 486-7070
NPI assigned
Oct 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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

Authorized official

Name
Maria E Saleh, DPMNPI 1497862767
Title
Owner
Phone
(920) 539-1902

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
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 801-25 WI Primary

Addresses

Primary practice location

355 N Peters Ave Ste 3
Fond Du Lac, WI 54935-8115

Mailing address

6400 Industrial Loop
Greendale, WI 53129-2452
Phone (414) 423-4110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121205000391 WI Part B Supplier - Clinic/Group Practice 3072765668 Receives reassigned benefits from 1 practitioner

National Provider Directory

National Provider Directory

Locations

109 Upland Dr
Brandon, WI 53919
Phone (920) 346-2105

355 N Peters Ave
Ste 3
Fond du Lac, WI 54935
Phone (920) 539-5400

701 S Main St
Fond du Lac, WI 54935
Phone (920) 922-5445

87 Wisconsin American Dr
Fond du Lac, WI 54937
Phone (920) 273-0335

769 Mustang Ln
Fond du Lac, WI 54935
Phone (920) 933-3733

345 E 1st St
Fond du Lac, WI 54935
Phone (920) 923-7980

300 Winnebago St
North Fond du Lac, WI 54937
Phone (920) 992-7242

515 S Webster Ave
Omro, WI 54963
Phone (920) 231-7900

1110 W Murdock Ave
Oshkosh, WI 54901
Phone (920) 252-4324

725 Butler Ave
Oshkosh, WI 54901
Phone (920) 235-5100

Practitioners & affiliated clinicians

Practitioners 5

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": "1351123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680739200000",
    "number": "1972856169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 INDUSTRIAL LOOP",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292452",
            "telephone_number": "414-423-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 N PETERS AVE STE 3",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549358115",
            "telephone_number": "920-539-5400",
            "fax_number": "920-486-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST FOOT AND WOUND CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-25",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A",
        "authorized_official_last_name": "SALEH",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-539-1902",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "WI",
            "license": "801-25",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.