NPIMap

Organization Active NPI

Foot Doctors of Kansas City, P.C.

  • Podiatrist
  • Lees Summit, MO
National Provider Identifier
1992306187
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
FOOT DOCTORS OF KANSAS CITY, P.C.
Practice address
224 NE Tudor Rd
Lees Summit, MO 64086-5696
Phone
(816) 525-4778
Fax
(816) 525-5761
NPI assigned
Nov 4, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Authorized official

Name
Julie A Boudreaux
Title
Office Manager
Phone
(816) 525-4778

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

224 NE Tudor Rd
Lees Summit, MO 64086-5696

Mailing address

224 NE Tudor Rd
Lees Summit, MO 64086-5696
Phone (816) 525-4778

Other practice location 1

115 Bradford Ln
Belton, MO 64012-2086
Phone (816) 322-3177

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20201120000422 MO Part B Supplier - Clinic/Group Practice 6901217066 Receives reassigned benefits from 4 practitioners
Practice locations: Belton, MO; Lees Summit, MO
O20210111000969 MO DME Supplier - Physician - Podiatry 6901217066 Practice locations: Lees Summit, MO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1604448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604448000000",
    "number": "1992306187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 NE TUDOR RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865696",
            "telephone_number": "816-525-4778",
            "fax_number": "816-525-5761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 NE TUDOR RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865696",
            "telephone_number": "816-525-4778",
            "fax_number": "816-525-5761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Bradford Ln",
            "address_purpose": "LOCATION",
            "city": "Belton",
            "state": "MO",
            "postal_code": "640122086",
            "country_code": "US",
            "telephone_number": "816-322-3177",
            "fax_number": "816-525-5761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FOOT DOCTORS OF KANSAS CITY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-04",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A",
        "authorized_official_last_name": "BOUDREAUX",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "816-525-4778"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; 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.