MISSOURI FOOT CARE CENTERS INC NPI 1316077209

NPI Information

NPI: 1316077209
Provider Name: MISSOURI FOOT CARE CENTERS, INC
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
1705 CHRISTY DR.
SUITE 209
JEFFERSON CITY, MO
ZIP 65101
Phone: (573) 634-3338
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MISSOURI FOOT CARE CENTERS, INC is a foot and ankle surgery podiatrist in Jefferson City, MO. MISSOURI FOOT CARE CENTERS, INC NPI is 1316077209. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1705 CHRISTY DR.
SUITE 209
JEFFERSON CITY, MO
ZIP 65101-195
Phone: (573) 634-3338
Fax: (573) 634-3985

The provider's authorized official is Kelli Jeane Ruddle .
The authorized official title is Office Manager and has the following contact phone number (636) 532-3131.

The enumeration date for this NPI number is 3/7/2007 and was last updated on 11/18/2011.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0103X	Podiatrist	Foot & Ankle Surgery	000552	MISSOURI	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	U89867	MEDICARE UPIN	MISSOURI
2	002012764	MEDICARE ID-TYPE UNSPECIFIED	MISSOURI	DR. TERRENCE KLAMET'S
3	364901504	MEDICAID	MISSOURI
4	1236280002	MEDICARE NSC
5	002012763	MEDICARE ID-TYPE UNSPECIFIED	MISSOURI	TERRENCE KLAMET, MEDICARE
6	30257410	MEDICAID	MISSOURI
7	504901505	MEDICAID	MISSOURI
8	T81014	MEDICARE UPIN	MISSOURI

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

NPI Synchronization or Removal

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