ADVANCED ANKLE AND FOOT SURGEONS, LLC (NPI# 1245563501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245563501 |
| Entity Type | Organization |
| Organization Name | ADVANCED ANKLE AND FOOT SURGEONS, LLC |
| Practice Address |
4905 Stone Falls Ctr Ste B O Fallon IL 62269-7802 |
| Practice Telephone | 6182770001 |
| Practice Fax Number | 6182777339 |
| Mailing Telephone | 6182770001 |
| Mailing Fax Number | 6182777339 |
| Enumeration Date | 2009-09-17 |
| Last Update Date | 2019-05-29 |
| Authorized Official Name | MICHELE TAYLOR (CFO) |
| Authorized Official Telephone | 6189601836 |
| Authorized Official Credential | JD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 016.004852 | IL | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | PTAN | 6242980002 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4600 Memorial Dr Ste 80, Belleville, IL 622265359 | 6182770001 | 6182777339 |
| 4905 Stone Falls Ctr Ste B, O Fallon, IL 622697802 | 6182770001 | 6182777339 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275773293 | Advanced Ankle and Foot Surgeons, LLC | Podiatrist | 4600 Memorial Dr, Suite 80, Belleville, IL 62226-5368 | 2009-03-03 |
| Street Address |
4905 STONE FALLS CTR STE B |
| City | O FALLON |
| State | IL |
| Zip Code | 62269-7802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648155 | Kayla Revermann | Pharmacist | 1350 W Us Highway 50, Pharmacy, O Fallon, IL 62269 | 2020-10-30 |
| 1942814272 | Ashley Monique Gibson | Behavior Technician | Eagle Center, Ste 10, Ofallon, IL 62269 | 2020-09-03 |
| 1013533819 | Michelle Denise Voudrie | Registered Nurse | 321 Regency Park, O'fallon, IL 62269 | 2020-06-18 |
| 1598398455 | Washington University Physicians In Illinois - Cancer Center Pharmacy | Pharmacy | 1418 Cross Street, Suite 180, Shiloh, IL 62269 | 2020-02-19 |
| 1962063800 | Gerald Paskert | Pharmacist | 122 W. State St., O'fallon, IL 62269 | 2019-06-21 |
| 1780144808 | Bonnie Jean Lampe | Physical Therapy Assistant | 316 Donna Dr, O'fallon, IL 62269 | 2019-03-24 |
| 1134633993 | Latisha Smith | Psychologist | 600 S. Smiley St., O'fallon, IL 62269 | 2017-11-30 |
| 1619407210 | Brenna M Thomas | Registered Nurse | 1310 Engle Ct, O'fallon, IL 62269 | 2017-06-15 |
| 1881135622 | Pc Associates, LLC | Family Medicine | 800 East Highway 50, O'fallon, IL 62269 | 2017-03-13 |
| 1700230539 | Jennifer Farrell | Family Medicine | 3 St. Elizabeth's Blvd, Ste. 4000, O'fallon, IL 62269 | 2016-04-18 |
| Find all providers in zip 62269 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710053566 | Veda E Lewis-simmons | Podiatrist | 475 Brookhaven Ct, O Fallon, MO 63368-9632 | 2006-11-24 |
| 1871679357 | Ddk Lc | Podiatrist | 300 Winding Woods Drive, Suite 214, O Fallon, MO 63366 | 2006-10-27 |
| 1144214529 | Daniel Douglas Kiddy | Podiatrist | 300 Winding Woods Dr, Ste 214, O Fallon, MO 63366-4771 | 2005-08-31 |
| 1629070487 | Linda L Porter | Podiatrist | 72 Rock Church Dr, O Fallon, MO 63368-8162 | 2005-08-11 |
| 1336141191 | Phann D Vu | Podiatrist | 5551 Winghaven Blvd, Ste 280, O Fallon, MO 63368-3629 | 2005-08-11 |
| 1497128938 | Feet for Miles | Podiatrist | 475 Brookhaven Ct, O Fallon, MO 63368-9632 | 2015-11-05 |
| 1154704344 | Randy Aaranson Dpm LLC | Podiatrist | 2917 Highway K, Suite G, O Fallon, MO 63368-7979 | 2015-07-07 |
| 1952563496 | Ddk, Lc | Podiatrist | 300 Winding Woods Dr, Suite 214, O Fallon, MO 63366-4771 | 2008-06-26 |
| 1871755306 | Ddk, LLC | Podiatrist | 300 Winding Woods Dr, Suite 214, O Fallon, MO 63366-4771 | 2008-06-26 |
| 1144482688 | Ddk, Lc | Podiatrist | 300 Winding Woods Dr, Suite 214, O Fallon, MO 63366-4771 | 2008-06-26 |
| Find all providers in O FALLON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.