Provider Demographics
NPI:1871863662
Name:NEXT STEP FOOT & ANKLE CENTERS
Entity Type:Organization
Organization Name:NEXT STEP FOOT & ANKLE CENTERS
Other - Org Name:TESSON FERRY FOOT & ANKLE, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:618-462-9695
Mailing Address - Street 1:3505 COLLEGE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-5065
Mailing Address - Country:US
Mailing Address - Phone:618-462-9695
Mailing Address - Fax:618-462-9651
Practice Address - Street 1:509 HAMACHER ST
Practice Address - Street 2:SUITE 202
Practice Address - City:WATERLOO
Practice Address - State:IL
Practice Address - Zip Code:62298-1592
Practice Address - Country:US
Practice Address - Phone:618-939-5979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO990001359Medicare PIN
IL210832Medicare PIN