Organization Active NPI

The Foot and Ankle Clinic LLC

  • Foot & Ankle Surgery Podiatrist
  • Lakewood, OH
National Provider Identifier
1992801658
Registry record updated Dec 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
THE FOOT AND ANKLE CLINIC LLC
Practice address
15644 Madison Ave
213
Lakewood, OH 44107-5622
Phone
(216) 227-2194
Fax
(216) 227-2196
NPI assigned
Sep 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2008

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

Authorized official

Name
Kristina M Kovach, DPM
Title
Owner
Phone
(216) 227-2194

Specialties & licenses 1

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

Addresses

Primary practice location

15644 Madison Ave
213
Lakewood, OH 44107-5622

Mailing address

PO Box 80690
Canton, OH 44708-0690
Phone (330) 833-5692

Other identifiers 1

IdentifierTypeStateIssuer
2035158MedicaidOH

National Provider Directory

National Provider Directory

Locations

8808 Tyler Blvd
Mentor, OH 44060
Phone (216) 227-2194

13500 Pearl Rd
Ste 139331
Strongsville, OH 44136

Practitioners & affiliated clinicians

Practitioners 1

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": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230249600000",
    "number": "1992801658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80690",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447080690",
            "telephone_number": "330-833-5692",
            "fax_number": "330-833-6085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15644 MADISON AVE",
            "address_2": "213",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441075622",
            "telephone_number": "216-227-2194",
            "fax_number": "216-227-2196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FOOT AND ANKLE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2008-12-26",
        "status": "A",
        "authorized_official_last_name": "KOVACH",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-227-2194",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2035158",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.