LAKE COUNTRY FOOT & ANKLE SC (NPI# 1245590017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245590017 |
| Entity Type | Organization |
| Organization Name | LAKE COUNTRY FOOT & ANKLE SC |
| Practice Address |
1177 Quail Ct Ste 103 Pewaukee WI 53072-3768 |
| Practice Telephone | 2626956440 |
| Practice Fax Number | 2626952668 |
| Mailing Telephone | 2626956440 |
| Mailing Fax Number | 2626952668 |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2012-05-25 |
| Authorized Official Name | DR. ETHAN DANIEL MEYER (PRESIDENT) |
| Authorized Official Telephone | 2626956440 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
794-025 | WI | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | P10 | 000082018 | 01 |
| Street Address |
1177 QUAIL CT STE 103 |
| City | PEWAUKEE |
| State | WI |
| Zip Code | 53072-3768 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982789210 | Lake Country Foot & Ankle, S.c. | Podiatrist | 1177 Quail Ct Ste 103, Pewaukee, WI 53072-3768 | 2006-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740805423 | Froedtert Health Neighborhood Hospital, LLC | General Acute Care Hospital | 209 Pewaukee Rd, Pewaukee, WI 53072 | 2020-06-09 |
| 1871122556 | Mary Kofigah | Nurse Practitioner | 21150 W. Capital Dr., Brookfield, WI 53072 | 2020-04-05 |
| 1609436559 | Brianna Kelly Bates | Optometrist | 1440 Capitol Drive, Suite B, Pewaukee, WI 53072 | 2019-06-13 |
| 1932767316 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1440 Capital Drive, Suite B, Pewaukee, WI 53072 | 2019-05-31 |
| 1417426925 | Edward Dow | Psychologist | W268n1988 Shooting Star Road, Pewaukee, WI 53072 | 2018-11-14 |
| 1346664869 | Jane Sweney | Counselor | 325 Forest Grove Drive, Pewaukee, WI 53072 | 2014-02-05 |
| 1093082182 | Kristin Elizabeth Thieneman | Pharmacist | 443 Pewaukee Road, Pewaukee, WI 53072 | 2011-11-17 |
| 1922318393 | Ariane Machin | Psychologist | 161 W. Wisconsin Ave #2b, Pewaukee, WI 53072 | 2010-10-19 |
| 1083930879 | Scott Robert Borkenhagen | Student in an Organized Health Care Education/Training Program | 384 Willow Grove Dr., Unit D, Pewaukee, WI 53072 | 2010-04-19 |
| 1912174988 | Robert Thomas Lynch | Dentist | 234 Oakton Ave, Pewaukee, WI 53072 | 2008-05-09 |
| Find all providers in zip 53072 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154632412 | Anton John Sella | Podiatrist | 2835 N Grandview Blvd Ste 300, Pewaukee, WI 53072-5591 | 2010-07-01 |
| 1982789210 | Lake Country Foot & Ankle, S.c. | Podiatrist | 1177 Quail Ct Ste 103, Pewaukee, WI 53072-3768 | 2006-10-26 |
| 1063660751 | Amy Louise Galati | Podiatrist | 2835 N Grandview Blvd, 300, Pewaukee, WI 53072-5546 | 2008-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225675697 | Grayco LLC | Podiatrist | 7128 Tamarack Ct, Mequon, WI 53092-8517 | 2019-12-04 |
| 1124688114 | Foot Factor Podiatry LLC | Podiatrist | 6125 Green Bay Rd Ste 600, Kenosha, WI 53142-2928 | 2019-06-20 |
| 1063928752 | Sheboygan Foot Care, LLC | Podiatrist | 630 Riverfront Dr Ste 202, Sheboygan, WI 53081-4616 | 2017-12-18 |
| 1295279461 | Colin T Graney | Podiatrist | 664 W. Washington Ave, Madison, WI 53703 | 2016-12-07 |
| 1790158368 | Wisconsin Visiting Podiatry | Podiatrist | 28606 Sandpiper Trl, Waterford, WI 53185-1733 | 2015-11-04 |
| 1225415540 | Alexander Blaschke | Podiatrist | 1009 Caledonia St, La Crosse, WI 54603 | 2015-05-06 |
| 1164861712 | Jessica Leigh Minder | Podiatrist | W62n179 Washington Ave Ste 3, Cedarburg, WI 53012-2770 | 2013-06-17 |
| 1326322884 | Northwoods Foot & Ankle LLC | Podiatrist | 1400 Us Highway 51 N, Unit G, Arbor Vitae, WI 54568-9504 | 2011-10-03 |
| 1336434075 | James David Torhorst | Podiatrist | 1439 Churchill St # 202, Waupaca, WI 54981-2089 | 2011-06-10 |
| 1861627184 | Ivelisse Vargas Jon | Podiatrist | 6510 W Layton Ave Ste 102, Greenfield, WI 53220-4563 | 2009-05-17 |
| Find all providers with the same taxonomy | ||||
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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.