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MIDWEST FOOT AND ANKLE LLC NPI 1780780023


NPI Information

NPI: 1780780023
Provider Name: MIDWEST FOOT AND ANKLE, LLC
Classification: Podiatrist - 213E00000X
Entity Type: Organization
Address:
3850 SHORE DR
SUITE 301
INDIANAPOLIS, IN
ZIP 46254
Phone: (317) 297-3338
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MIDWEST FOOT AND ANKLE, LLC is a podiatrist in Indianapolis, IN. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. MIDWEST FOOT AND ANKLE, LLC NPI is 1780780023. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3850 SHORE DR
SUITE 301
INDIANAPOLIS, IN
ZIP 46254-621
Phone: (317) 297-3338

The provider's authorized official is Kirk S Holston .
The authorized official title is Owner and has the following contact phone number (317) 297-3338.

The enumeration date for this NPI number is 9/15/2006 and was last updated on 1/8/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1213E00000XPodiatrist070000768AINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1200527610BMEDICAIDINDIANA
25392850003MEDICARE NSC
30005497063OTHERINDIANAAETNA
45392850001MEDICARE NSC
5224160MEDICARE PININDIANA
6000000364508OTHERINDIANAANTHEM BCBS
75392850002MEDICARE NSC
8=========OTHERINDIANATRICARE
95392850004MEDICARE NSC
10U38164MEDICARE UPININDIANA
11201450MEDICARE ID-TYPE UNSPECIFIEDINDIANACITIZENS
12200527610AMEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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