MEDICARE: HAPPY FEET PODIATRY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363A00000X	Physician Assistant
2	363L00000X	Nurse Practitioner
3	213E00000X	Podiatrist

General Provider Information

NPI Number	:	1184540254
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAPPY FEET PODIATRY LLC

Provider Business Mailing Address
First Line	:	PO BOX 38
Second Line	:
City	:	KAHOKA
State	:	MO
Zip	:	63445-0038
Country	:	US
Telephone Number	:	660-727-6890
Fax Number	:	660-727-6249

Provider Business Practice Location Address
First Line	:	107 W COMMERCIAL ST
Second Line	:
City	:	KAHOKA
State	:	MO
Zip	:	63445-1411
Country	:	US
Telephone Number	:	660-727-6890
Fax Number	:	660-727-6249

Authorized Official
Title or Position	:	ADVISOR
Name	:	NICOLE DAVIS
Credential	:
Telephone Number	:	660-727-6890

Provider Enumeration Date	:	06/24/2026
Last Update Date	:	06/24/2026

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Directions to “HAPPY FEET PODIATRY LLC ” Practice Location

Language	Start Address	Practice Location

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