Mid-Missouri Foot and Ankle Center
Organization Active NPI Foot & Ankle Surgery Podiatrist · Rolla, MO
NPI 1982667366 · NPPES record last updated Sep 12, 2008
Key facts
- NPI
- 1982667366
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Foot & Ankle Surgery Podiatrist 213ES0103X
- Legal business name
- MID-MISSOURI FOOT AND ANKLE CENTER
- Practice address
- 1210 Homelife PLZ
Rolla, MO 65401-2512 - Phone
- (573) 341-2971
- Fax
- (573) 341-8174
- NPI assigned
- Apr 7, 2006
- Organization subpart
- No
Authorized official
- Name
- Kara Watson
- Title
- Practice Manager
- Phone
- (573) 341-2971
Practitioners 2
-
Sharon R Anderson, DPM
-
Dixie Fox, DPM
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D1011636 | Mid Missouri Foot & Ankle Ctr Inc | Certificate of waiver | Apr 15, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
Locations
1331 S Sam Houston Blvd
Houston, MO 65483
35629 Highway 72
Salem, MO 65560
Phone (573) 729-8000
35629 Highway 72
Ste 2
Salem, MO 65560
202 N Lynn St
Waynesville, MO 65583
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist |
213ES0103X | MO | Yes |
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
- Anderson Foot Clinic
Other providers in Rolla, MO
- Mercy Hospital Springfield
- Mercy Pharmacy Services, LLC
- Derrick Meyers
- Mi Serenity
- Nathan Micklautz
- Mid-Missouri Internal Medicine Inc
- Mid-Mo O&P LLC
- Angela Christine Middleton
- Midwest Chiropractic Center LLC
- Midwest Heart Group of Rolla, LLC
All providers in Rolla, MO · Foot & Ankle Surgery Podiatrist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.