Provider Demographics
NPI:1760621924
Name:ACTIVE FOOT SOLUTIONS PA
Entity Type:Organization
Organization Name:ACTIVE FOOT SOLUTIONS PA
Other - Org Name:AMBER S. BEISIEGEL, D.P.M.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:STEINFORD
Authorized Official - Last Name:BEISIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:913-649-6677
Mailing Address - Street 1:10318 WALMER ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-1741
Mailing Address - Country:US
Mailing Address - Phone:913-649-6677
Mailing Address - Fax:913-649-6679
Practice Address - Street 1:10464 METCALF AVE
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-1806
Practice Address - Country:US
Practice Address - Phone:913-649-6677
Practice Address - Fax:913-649-6679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12-00313213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS6244820001Medicare NSC