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PREMIER PODIATRY
NPI 1720445281
Podiatrist in Long Grove, IA

Active since January 28, 2016
405 WOODLAWN RD, LONG GROVE, IA 52756(832) 425-7457(563) 424-7234 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 21, 2022, Jul 13, 2017, Mar 2, 2016 and 1 more (4 updates tracked since 2016).

About Premier Podiatry NPPES

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

PREMIER PODIATRY (NPI 1720445281) is a healthcare organization registered as a podiatrist in Long Grove, Iowa and active in the NPI registry since January 2016. The organization lists James P Licandro, Owner/physician, as its authorized official.

NPPES Registry Identity

NPI1720445281
Entity TypeOrganization
Primary Taxonomy213E00000X
Legal Business NamePREMIER PODIATRY
Location Address405 WOODLAWN RDLong Grove, IA 52756-8745
Mailing AddressPo Box 2671Davenport, IA 52809-2671 · (832) 425-7457 · Fax (563) 285-5447
Phone(832) 425-7457
Fax(563) 424-7234
Organization SubpartNo
Authorized OfficialJames P LicandroOwner/physician · (563) 340-4387
Enumeration DateJanuary 28, 2016
Last NPPES UpdateJuly 21, 20224 updates tracked since enumeration
✔ NPI 1720445281 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
License✔ Licensed in IA · 0705
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.

405 WOODLAWN RD, Long Grove, IA 52756
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JIM PAUL LICANDRO DPM
Podiatrist
405 WOODLAWN RD
LONG GROVE, IA 52756
Scott County (832) 425-7457

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 Premier Podiatry's NPI number?

The NPI number for Premier Podiatry is 1720445281. It was assigned to this organization in the NPPES registry on January 28, 2016.

Where is Premier Podiatry located?

Premier Podiatry is located at 405 Woodlawn Rd, Long Grove, IA 52756. The listed phone number is (832) 425-7457.

What is Premier Podiatry's specialty?

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

When was this NPI record last updated?

The NPPES record for Premier Podiatry was last updated on July 21, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.