Provider Demographics
NPI:1184921280
Name:FOOT CARE PLUS LLC
Entity type:Organization
Organization Name:FOOT CARE PLUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:N
Authorized Official - Last Name:TON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:816-286-0106
Mailing Address - Street 1:PO BOX 1139
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063-8139
Mailing Address - Country:US
Mailing Address - Phone:816-225-2557
Mailing Address - Fax:816-434-5748
Practice Address - Street 1:305 SE INDEPENDENCE AVE
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-2827
Practice Address - Country:US
Practice Address - Phone:816-225-2557
Practice Address - Fax:816-434-5748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-25
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO45892019OtherBCBS/ANTHEM
MO6550080001Medicare NSC
MOMA3402Medicare PIN