Provider Demographics
NPI:1750503082
Name:WESTERN PLAINS FOOT CENTER, P.C.
Entity Type:Organization
Organization Name:WESTERN PLAINS FOOT CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SWARTZKOPF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-632-3668
Mailing Address - Street 1:2 W 42ND ST
Mailing Address - Street 2:STE 2700
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-0617
Mailing Address - Country:US
Mailing Address - Phone:308-632-3668
Mailing Address - Fax:308-635-1355
Practice Address - Street 1:2 W 42ND ST
Practice Address - Street 2:STE 2700
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-0617
Practice Address - Country:US
Practice Address - Phone:308-632-3668
Practice Address - Fax:308-635-1355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE261213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE02560OtherBLUE CROSS
NE=========07Medicaid
NE098838Medicare ID - Type Unspecified
NE1201140001Medicare ID - Type UnspecifiedDMERC MEDICARE #
NE02560OtherBLUE CROSS
NEU61958Medicare UPIN