Organization Active NPI

Lake Country Foot & Ankle, S.C.

  • Foot & Ankle Surgery Podiatrist
  • Pewaukee, WI
National Provider Identifier
1982789210
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
794025 Issued in WI
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, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

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)CodeLicenseStatePrimary
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 Directory

NPI 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.

Verify at the official NPI Registry.