Healthcare Provider Details

I. General information

NPI: 1518321769
Provider Name (Legal Business Name): SPECIAL CARE PODIATRY KS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2016
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 SW WANAMAKER RD STE 103
TOPEKA KS
66604-3805
US

IV. Provider business mailing address

4350 BROWNSBORO RD STE 210
LOUISVILLE KY
40207-1681
US

V. Phone/Fax

Practice location:
  • Phone: 502-244-2420
  • Fax: 502-996-8282
Mailing address:
  • Phone: 248-528-2116
  • Fax: 502-996-8282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number12-00421
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JOY L STEVENS
Title or Position: VP OF REVENUE ASSURANCE
Credential:
Phone: 502-244-2441