MID-WEST PODIATRY & ASSOCIATES LLC NPI 1821153636

NPI Information

NPI: 1821153636
Provider Name: MID-WEST PODIATRY & ASSOCIATES, LLC
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

CLIA Number: 26D1039099

Address:
11709 OLD BALLAS RD
SUITE 201
CREVE COEUR, MO
ZIP 63141
Phone: (314) 432-1903
Get Directions

MID-WEST PODIATRY & ASSOCIATES, LLC is a foot and ankle surgery podiatrist in Creve Coeur, MO. MID-WEST PODIATRY & ASSOCIATES, LLC NPI is 1821153636. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

11709 OLD BALLAS RD
SUITE 201
CREVE COEUR, MO
ZIP 63141-029
Phone: (314) 432-1903
Fax: (314) 432-5105

The provider's authorized official is Sandy Pike .
The authorized official title is Administrator and has the following contact phone number (314) 432-1903.

The CLIA number assigned to this NPI record is 26D1039099 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/22/2006 and was last updated on 10/8/2009.

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			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	000012738	MEDICARE ID-TYPE UNSPECIFIED	MISSOURI	URBAN
2	000012739	MEDICARE ID-TYPE UNSPECIFIED	MISSOURI	RURAL
3	365906405	MEDICAID	MISSOURI
4	365905413	MEDICAID	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: 5/5/2024

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