Active NPI
Lake Country Foot & Ankle, S.C.
- Foot & Ankle Surgery Podiatrist
- Pewaukee, WI
National Provider Identifier
1982789210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 794025
- Legal business name
- LAKE COUNTRY FOOT & ANKLE, S.C.
- Practice address
- 1177 Quail CT Ste 103
Pewaukee, WI 53072-3768 - Phone
- (262) 695-6440
- Fax
- (262) 695-2668
- NPI assigned
- Oct 26, 2006
- Last updated
- Aug 13, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mary M Foster
- Title
- Office Manager
- Phone
- (262) 695-6440
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 794025 | WI | Primary |
Addresses
Primary practice location
1177 Quail CT Ste 103
Pewaukee, WI 53072-3768
Mailing address
1177 Quail CT Ste 103
Pewaukee, WI 53072-3768
Phone (262) 695-6440
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1218585600000",
"number": "1982789210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1177 QUAIL CT STE 103",
"city": "PEWAUKEE",
"state": "WI",
"postal_code": "530723768",
"telephone_number": "262-695-6440",
"fax_number": "262-695-2668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1177 QUAIL CT STE 103",
"city": "PEWAUKEE",
"state": "WI",
"postal_code": "530723768",
"telephone_number": "262-695-6440",
"fax_number": "262-695-2668"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LAKE COUNTRY FOOT & ANKLE, S.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-26",
"last_updated": "2008-08-13",
"status": "A",
"authorized_official_last_name": "FOSTER",
"authorized_official_first_name": "MARY",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "262-695-6440"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "WI",
"license": "794025",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pewaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.