Provider Demographics
NPI:1528011418
Name:FIRST CHOICE ANKLE & FOOT CARE CENTER, PLLC
Entity Type:Organization
Organization Name:FIRST CHOICE ANKLE & FOOT CARE CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEIKO
Authorized Official - Middle Name:B
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:502-633-3338
Mailing Address - Street 1:1701 MIDLAND TRL
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-1711
Mailing Address - Country:US
Mailing Address - Phone:502-633-3338
Mailing Address - Fax:502-633-2704
Practice Address - Street 1:1701 MIDLAND TRL
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-1711
Practice Address - Country:US
Practice Address - Phone:502-633-3338
Practice Address - Fax:502-633-2704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00286213ES0103X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY80900327Medicaid
KY90013889Medicaid
KY50011065OtherPASSPORT
KY2734381000OtherPASSPORT ADVANTAGE
KY50013637OtherPASSPORT DME
KY=========OtherTRICARE
KY2734381000OtherPASSPORT ADVANTAGE
KYDE9338Medicare Oscar/Certification
KY50011065OtherPASSPORT