TACKLE MANAGEMENT CORPORATION (NPI# 1033399688) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033399688 |
| Entity Type | Organization |
| Organization Name | TACKLE MANAGEMENT CORPORATION |
| Other Organization Name | BULL RUN FOOT CLINIC |
| Practice Address |
8637 Mathis Ave Manassas VA 20110-5270 |
| Practice Telephone | 7033356890 |
| Mailing Telephone | 7033356890 |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2007-11-13 |
| Authorized Official Name | MISS THERESA LYNN COATES (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 7033681800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
VA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | ANTHEM | 296209 | 01 |
| Other Name | Type Code |
|---|---|
| BULL RUN FOOT CLINIC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831212067 | Tackle Management Corporation | Podiatrist | 8637 Mathis Ave, Manassas, VA 20110-5270 | 2007-04-10 |
| Street Address |
8637 MATHIS AVE |
| City | MANASSAS |
| State | VA |
| Zip Code | 20110-5270 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831212067 | Tackle Management Corporation | Podiatrist | 8637 Mathis Ave, Manassas, VA 20110-5270 | 2007-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184246787 | Sini Eapen | Nurse Practitioner | 9380 Forestwood Lane, 9380 Unit B, Manassas, VA 20110 | 2020-05-18 |
| 1023662202 | United Health Home Care Agency | Registered Nurse | 8789 Commerce Ct#202, Manassas, VA 20110 | 2019-07-26 |
| 1750868097 | Elaine K. Sours, D.d.s., P.C. | Dentist | 8719 Plantation Lane, Manassas, VA 20110 | 2018-07-19 |
| 1962904573 | Donielle Francis | Specialist/Technologist | 10420 Monterosa Pl, Manassas, VA 20110 | 2018-02-28 |
| 1003332354 | Katrina Kask | Occupational Therapist | 6985 Centreville Rd., Manassas, VA 20110 | 2017-08-18 |
| 1477091478 | Mega Health Services, Inc | General Practice | 9602 Champion Ct, Manassas, VA 20110 | 2017-02-09 |
| 1811340599 | Malik Usman Dds, PC | Dentist | 8559 Sudley Road, Manassas, VA 20110 | 2016-07-19 |
| 1871944660 | Chitra Subbaraj | Physical Therapist | 8595 Centreville Rd, Manassas, VA 20110 | 2016-06-23 |
| 1093186512 | Daczkowski Orthodontics | Dentist | 8715 Stonewall Road, Manassas, VA 20110 | 2015-10-09 |
| 1851770366 | Candace Fleming | Counselor | 9242b Mosby St, Manassas, VA 20110 | 2015-05-29 |
| Find all providers in zip 20110 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104300359 | Vineela Ayyagari | Podiatrist | 9017 Fletcher Farm Ct, Manassas, VA 20112-5867 | 2018-09-23 |
| 1457640815 | Dr Victor Coates, P.C. | Podiatrist | 8551 Sudley Rd, Manassas, VA 20110-3803 | 2011-04-06 |
| 1831212067 | Tackle Management Corporation | Podiatrist | 8637 Mathis Ave, Manassas, VA 20110-5270 | 2007-04-10 |
| 1902967433 | Victor B Coates Dpm PC | Podiatrist | 8709 Professional Pl Ste A, Manassas, VA 20110-4424 | 2006-12-12 |
| 1760579676 | Victor Brian Coates | Podiatrist | 9550 Surveyor Ct, Manassas, VA 20110-4406 | 2006-10-10 |
| 1528388824 | Akbar Abyaneh | Podiatrist | 8704 Rolling Rd, Manassas, VA 20110 | 2010-06-09 |
| 1780852319 | Shaun Charles Hafner | Podiatrist | 8577 Sudley Rd, Suite A, Manassas, VA 20110-3810 | 2008-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952909228 | The Ankle and Foot Clinic of Northern Virginia, Pllc | Podiatrist | 12628 Tide View Ct, Bristow, VA 20136-1175 | 2020-10-09 |
| 1912542713 | Michael A Dente Jr Dpm Plc | Podiatrist | 356 Mclaws Cir Ste 1, Williamsburg, VA 23185-6345 | 2019-11-15 |
| 1609431964 | Ana Anahit Emirzian | Podiatrist | 3300 Gallows Road, Original Building, Falls Church, VA 22042-3307 | 2019-05-02 |
| 1508329913 | District Foot and Ankle | Podiatrist | 4875 Eisenhower Ave Ste 230, Alexandria, VA 22304-4833 | 2019-04-11 |
| 1083137871 | Rural Podiatry, LLC | Podiatrist | 7010 Mountain Rd, Halifax, VA 24558-2392 | 2017-07-24 |
| 1356863781 | Chen Foot & Ankle Center LLC | Podiatrist | 1948 Jenkins Mill Rd, Suffolk, VA 23437-9401 | 2017-07-07 |
| 1568982247 | Soumaya Bader | Podiatrist | 632 Cedar Rd Ste B, Chesapeake, VA 23322-8376 | 2017-06-22 |
| 1013440569 | Richard Bruno | Podiatrist | 2790 Godwin Blvd Ste 355, Suffolk, VA 23434-8173 | 2017-04-11 |
| 1497289961 | David Chan | Podiatrist | 224d Cornwall St Nw # 203100, Leesburg, VA 20176-2713 | 2017-04-11 |
| 1457808933 | Evergreen Foot and Ankle LLC | Podiatrist | 6928 Little River Turnpike, Suite B, Annandale, VA 22003 | 2016-09-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.