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MOBERLY FOOT CLINIC
NPI 1154341592
Podiatrist in Moberly, MO

Active since July 20, 2006
1513 UNION AVE, SUITE 1400, MOBERLY, MO 65270(660) 263-6688(660) 263-6688 Get Directions Write a Review

NPPES record last updated: April 20, 2008. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Moberly Foot Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOBERLY FOOT CLINIC (NPI 1154341592) is a healthcare organization registered as a podiatrist in Moberly, Missouri and active in the NPI registry since July 2006. The organization lists Jonathon Lee Fallis, Owner, as its authorized official.

NPPES Registry Identity

NPI1154341592
Entity TypeOrganization
Primary Taxonomy213E00000X
Legal Business NameJONATHON FALLIS DPM LLC
Location Address1513 UNION AVE, SUITE 1400Moberly, MO 65270
Mailing Address1513 Union Ave, Suite 1400Moberly, MO 65270 · (660) 263-6677 · Fax (660) 263-6688
Phone(660) 263-6688
Fax(660) 263-6688
Organization SubpartNo
Authorized OfficialJonathon Lee FallisOwner · (660) 263-6677
Enumeration DateJuly 20, 2006
Last NPPES UpdateApril 20, 2008
✔ NPI 1154341592 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
Licenses✔ Licensed in IL · 016004851✔ Licensed in MO · 2002006341
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
1513 UNION AVE, Moberly, MO 65270
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Other Names 1

Doing Business AsMoberly Foot Clinic

Other Identifiers 7

Other154392MO · Bcbs
Medicaid=========052701IL
Other5502300001MO · Medicare Dmerc
OtherP0038451MO · Railroad Medicare
Medicaid=========6527001IL
Medicare UPINU67452
Medicare PIN214127IL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Moberly Foot Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by October 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateMissouriEnrollment IDO20100930073247DME · Physician - PodiatryDue dateOctober 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Moberly Foot Clinic, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jonathon Fallis, DPM
Podiatry
NPI 1659391084
1513 UNION AVE SUITE 1400
Moberly, MO 65270
(660) 263-6677
✔ PECOS✔ Accepts Medicare0.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jonathon Fallis Dpm LLC's NPI number?

The NPI number for Jonathon Fallis Dpm LLC is 1154341592. It was assigned to this organization in the NPPES registry on July 20, 2006. The provider is doing business as Moberly Foot Clinic.

Where is Jonathon Fallis Dpm LLC located?

Jonathon Fallis Dpm LLC is located at 1513 Union Ave Suite 1400, Moberly, MO 65270. The listed phone number is (660) 263-6688.

What is Jonathon Fallis Dpm LLC's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Is Jonathon Fallis Dpm LLC enrolled in Medicare?

Yes. Jonathon Fallis Dpm LLC is registered in the Medicare PECOS enrollment system.

When is Jonathon Fallis Dpm LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (Missouri, Physician - Podiatry) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Jonathon Fallis Dpm LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Podiatry) reassigns their Medicare billing to Jonathon Fallis Dpm LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Jonathon Fallis Dpm LLC was last updated on April 20, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.