Organization Active NPI

Mid-Missouri Foot and Ankle Center

Doing business as Anderson Foot Clinic

  • Foot & Ankle Surgery Podiatrist
  • Rolla, MO
National Provider Identifier
1982667366
Registry record updated Sep 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
MID-MISSOURI FOOT AND ANKLE CENTER
Doing business as
Anderson Foot Clinic
Practice address
1210 Homelife PLZ
Rolla, MO 65401-2512
Phone
(573) 341-2971
Fax
(573) 341-8174
NPI assigned
Apr 7, 2006
Last updated
Sep 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2008

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

Authorized official

Name
Kara Watson
Title
Practice Manager
Phone
(573) 341-2971

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X MO Primary

Addresses

Primary practice location

1210 Homelife PLZ
Rolla, MO 65401-2512

Mailing address

PO Box 130
Rolla, MO 65402-0130
Phone (573) 341-2971

Other names 1

  • Anderson Foot Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040925000018 MO Part B Supplier - Clinic/Group Practice 7618946856 Receives reassigned benefits from 2 practitioners
Practice locations: Rolla, MO
O20100930030554 MO DME Supplier - Physician - General Practice 7618946856 Practice locations: Rolla, MO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D1011636Mid Missouri Foot & Ankle Ctr Inc1210 Homelife Drive, Rolla, MO 65401Certificate of waiverApr 15, 2027

National Provider Directory

National Provider Directory

Locations

35629 Highway 72
Ste 2
Salem, MO 65560

202 N Lynn St
Waynesville, MO 65583

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221177600000",
    "number": "1982667366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654020130",
            "telephone_number": "573-341-2971",
            "fax_number": "573-341-8174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 HOMELIFE PLZ",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012512",
            "telephone_number": "573-341-2971",
            "fax_number": "573-341-8174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-MISSOURI FOOT AND ANKLE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-07",
        "last_updated": "2008-09-12",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "KARA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "573-341-2971"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anderson Foot Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rolla, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.