Healthcare Provider Details

I. General information

NPI: 1013083823
Provider Name (Legal Business Name): CENTER FOR FOOT AND ANKLE CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3747 MAIN ST
WEIRTON WV
26062-5309
US

IV. Provider business mailing address

3747 MAIN ST
WEIRTON WV
26062-5309
US

V. Phone/Fax

Practice location:
  • Phone: 304-797-0190
  • Fax: 304-797-1187
Mailing address:
  • Phone: 304-797-0190
  • Fax: 304-797-1187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number00238
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License Number00238
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number00238
License Number StateWV
# 4
Primary TaxonomyY
Taxonomy Code213ER0200X
TaxonomyRadiology Podiatrist
License Number00238
License Number StateWV

VIII. Authorized Official

Name: DR. JEFFREY B WILPS
Title or Position: PRESIDENT
Credential: D.P.M.
Phone: 304-797-0190