Provider Demographics
NPI:1548358732
Name:ELEVATE FOOT & ANKLE, INC
Entity type:Organization
Organization Name:ELEVATE FOOT & ANKLE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:KRETCH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:440-465-8810
Mailing Address - Street 1:2880 PLYMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-3209
Mailing Address - Country:US
Mailing Address - Phone:440-333-5888
Mailing Address - Fax:440-333-6766
Practice Address - Street 1:2880 PLYMOUTH AVE
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3209
Practice Address - Country:US
Practice Address - Phone:440-333-5888
Practice Address - Fax:440-333-6766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2025-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH826250213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0942565Medicaid
OH0942565Medicaid
OH1180940001Medicare NSC