Healthcare Provider Details

I. General information

NPI: 1114417078
Provider Name (Legal Business Name): HEARTLAND FOOT & ANKLE CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2018
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 W MOUNT PLEASANT ST
WEST BURLINGTON IA
52655-1235
US

IV. Provider business mailing address

209 S WHITE ST
MT PLEASANT IA
52641-2157
US

V. Phone/Fax

Practice location:
  • Phone: 319-753-1223
  • Fax: 319-753-1171
Mailing address:
  • Phone: 319-385-1128
  • Fax: 319-385-1129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number00535
License Number StateIA

VIII. Authorized Official

Name: JOHN KEVIN HART
Title or Position: DOCTOR
Credential: DPM
Phone: 319-385-1128