Provider Demographics
NPI:1770527889
Name:A STEP AHEAD FOOT AND ANKLE CENTER LLC
Entity type:Organization
Organization Name:A STEP AHEAD FOOT AND ANKLE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:M
Authorized Official - Last Name:KNUTSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:970-493-4660
Mailing Address - Street 1:2001 S SHIELDS ST STE F
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-1833
Mailing Address - Country:US
Mailing Address - Phone:970-493-4660
Mailing Address - Fax:970-493-6710
Practice Address - Street 1:2001 S SHIELDS ST STE F
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-1833
Practice Address - Country:US
Practice Address - Phone:970-493-4660
Practice Address - Fax:970-493-6710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2023-03-28
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
CO46973541Medicaid
CO5024980001OtherSUPPLIER NUMBER
CODA5007OtherRAILROAD MEDICARE
CO46973541Medicaid
C522428Medicare PIN