Western Reserve Foot Clinic – Podiatrist, NPI 1619192655

Western Reserve Foot Clinic is a healthcare provider. based in Stow, Ohio. specializing in Podiatrist. The organization holds a License No. 36-00-2719 (OH). The NPI Number for Western Reserve Foot Clinic is 1619192655

Main info

Organization
Name
Western Reserve Foot Clinic
NPI
1619192655
Phone
(330) 689-3338
Address
4495 DARROW RD
Authorized Official
DR. KENNETH HARLEY NIXON PRESIDENT D.P.M.
Enumeration Date
16 April 2007
Last Update Date
23 April 2009
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness80
Years active:19State licenses:1Digital endpointsUpdated within 12 months

Provider Addresses for Western Reserve Foot Clinic

  • 4495 DARROW RD

    STOW, OH 442241854

    Phone: (330) 689-3338

    Fax: (330) 689-0282

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-09-30

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-09-30 (623 days ago).

Enrollment records

2

Earliest due date

2024-09-30

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20100317001129OClinic/Group PracticeOH2024-09-30
O20100930078083OPhysician - PodiatryOH2025-06-30

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44224)

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Reviews

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Frequently asked questions

What is the registry number for Western Reserve Foot Clinic?
The registry entry for Western Reserve Foot Clinic shows NPI 1619192655.
Does the public listing show Western Reserve Foot Clinic as active?
Western Reserve Foot Clinic's NPI record reflects an active status in NPPES.
Which specialty label fits Western Reserve Foot Clinic?
NPPES ties Western Reserve Foot Clinic to Podiatrist in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to Western Reserve Foot Clinic?
The directory associates Western Reserve Foot Clinic with Stow, Ohio. Check all listed addresses for suites or satellite offices.
Why is information missing for Western Reserve Foot Clinic?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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