Provider Demographics
NPI:1982826111
Name:ANKLE & FOOT CLINIC PC
Entity Type:Organization
Organization Name:ANKLE & FOOT CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:R
Authorized Official - Last Name:DINUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:402-331-0221
Mailing Address - Street 1:8625 Q ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-3673
Mailing Address - Country:US
Mailing Address - Phone:402-331-0221
Mailing Address - Fax:402-331-9903
Practice Address - Street 1:8625 Q ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-3673
Practice Address - Country:US
Practice Address - Phone:402-331-0221
Practice Address - Fax:402-331-9903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE300213E00000X
213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025339700Medicaid
NE10025339700Medicaid
099800Medicare PIN
NE0763910001Medicare NSC