PREMIER FOOT & ANKLE SURGEONS OF IOWA PLLC (NPI# 1205483765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205483765 |
| Entity Type | Organization |
| Organization Name | PREMIER FOOT & ANKLE SURGEONS OF IOWA PLLC |
| Other Organization Name | PREMIER FOOT & ANKLE SURGEONS OF IOWA |
| Practice Address |
255 Sw Brookside Dr Ste 200 Grimes IA 50111-5244 |
| Practice Telephone | 5155006568 |
| Practice Fax Number | 5152068371 |
| Mailing Telephone | 5155006568 |
| Mailing Fax Number | 5152068371 |
| Enumeration Date | 2019-08-20 |
| Last Update Date | 2020-10-29 |
| Authorized Official Name | DR. DREW MICHAEL DAVIDSON (SOLE MANAGING MEMBER) |
| Authorized Official Telephone | 5155006568 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP1100X |
Clinic/Center Specialization: Podiatric |
Ambulatory Health Care Facilities | ||
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0125134 | 05 | |
| IA | 2207464 | 05 |
| Other Name | Type Code |
|---|---|
| Premier Foot & Ankle Surgeons of Iowa | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | PREMIER FOOT & ANKLE SURGEONS OF IOWA PLLC | 255 Sw Brookside Dr., Ste 200, Grimes, IA 50111 |
| Street Address |
255 SW BROOKSIDE DR STE 200 |
| City | GRIMES |
| State | IA |
| Zip Code | 50111-5244 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760894323 | Drew Michael Davidson | Podiatrist | 255 Sw Brookside Dr, Ste 200, Grimes, IA 50111-5244 | 2014-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013200914 | Ccrc of Grimes, LLC | Skilled Nursing Facility | 200 Sw Brookside Drive, Grimes, IA 50111 | 2011-05-25 |
| 1891000147 | Wal-mart Stores Inc | Technician/Technologist | 2150 East 1st St., Grimes, IA 50111 | 2010-08-11 |
| 1134364573 | Tram Quach | Pharmacist | 608 South 18th Street, Grimes, IA 50111 | 2008-12-15 |
| 1730338625 | Ann Marie Miller | Pharmacist | 5700 Glenstone Dr, Unit 701, Grimes, IA 50111 | 2008-09-16 |
| 1548481591 | Siebert Mobility, Inc. | Contractor | 3450 Se Miehe Drive, Suite 1, Grimes, IA 50111 | 2007-05-01 |
| 1275691867 | Nicholas John Nerem | Chiropractor | 925 Gateway Dr., Suite 200, Grimes, IA 50111 | 2006-12-05 |
| 1932275252 | Holly Marie Crowson | Chiropractor | 3000 Se Grimes Blvd, Suite 500, Grimes, IA 50111 | 2006-11-28 |
| 1235158452 | Amanda Jorgensen | Dentist | 100 Sw Brookside Dr, Grimes, IA 50111 | 2006-07-19 |
| 1922065903 | Curtis R Waddingham | Specialist/Technologist | 270 Sw 1st St, Ste H, Grimes, IA 50111 | 2006-04-26 |
| 1326011578 | Grove and Platt Dental Associates Plc | Dentist | 1541 S Third Street, Suite 300, Grimes, IA 50111 | 2006-02-08 |
| Find all providers in zip 50111 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578189296 | Linda Bratkiewicz Podiatry Pllc | Podiatrist | 1301 Pennsylvania Ave Ste 115, Des Moines, IA 50316-2364 | 2020-06-18 |
| 1407377344 | Fusion Foot and Ankle, LLC | Podiatrist | 110 Us Hwy 6 Suite 80, Waukee, IA 50263 | 2017-06-30 |
| 1629429451 | Nathan Charles Shumway | Podiatrist | 320 Mckenzie Ave Ste 102, Council Bluffs, IA 51503 | 2016-06-22 |
| 1780068114 | Kara Franzen | Podiatrist | 1500 Delhi St Ste 2200, Dubuque, IA 52001-6359 | 2015-07-15 |
| 1265835474 | Iowa Foot & Ankle Specialists, Pllc | Podiatrist | 2884 Aaa Ct, Bettendorf, IA 52722-3406 | 2014-10-01 |
| 1932462256 | Jennifer Ann Fuehrer | Podiatrist | 1327 Sunset Drive, Suite 300, Norwalk, IA 50211 | 2012-06-21 |
| 1912278490 | Collin E. Pehde Dpm, Pllc | Podiatrist | 500 E Court Ave, Suite 314, Des Moines, IA 50309-2057 | 2012-01-16 |
| 1912285479 | Joshua R Modlin | Podiatrist | 4214 Fleur Dr Ste 7, Des Moines, IA 50321-2300 | 2011-08-01 |
| 1326336397 | Brian David Hunziker | Podiatrist | 80 E Hickman Rd, Waukee, IA 50263-5011 | 2011-07-12 |
| 1306175104 | Justin J. Raatz | Podiatrist | 500 E Court Ave Ste 314, Des Moines, IA 50309-2057 | 2009-12-08 |
| 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.