FOOT AND ANKLE RECONSTRUCTION CENTER OF GEORGIA LLC (NPI# 1043773914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043773914 |
| Entity Type | Organization |
| Organization Name | FOOT AND ANKLE RECONSTRUCTION CENTER OF GEORGIA LLC |
| Practice Address |
1025 E Freeway Dr Se Conyers GA 30094-5965 |
| Practice Telephone | 9374774445 |
| Mailing Telephone | 7709293338 |
| Mailing Fax Number | 7707607942 |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2019-08-22 |
| Authorized Official Name | DARRICE COLLINS (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 9374774445 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers |
| Street Address |
1025 E FREEWAY DR SE |
| City | CONYERS |
| State | GA |
| Zip Code | 30094-5965 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356323778 | James Edwin Williams Jr. | Podiatrist | 1025 E Freeway Dr Se, Conyers, GA 30094-5965 | 2005-11-20 |
| 1164812202 | Alvin Jeffrey Cowans II | Podiatrist | 1025 E Freeway Dr Se, Conyers, GA 30094-5965 | 2015-01-28 |
| 1760802268 | Darrice Collins | Podiatrist | 1025 E Freeway Dr Se, Conyers, GA 30094 | 2014-04-23 |
| 1063697951 | Ankle and Foot Specialists of Rockdale | Podiatrist | 1025 E Freeway Dr Se, Conyers, GA 30094-5965 | 2008-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029054 | Darlene Fletcher | Counselor | 827 St. Clair Dr., Conyers, GA 30094 | 2020-10-05 |
| 1194363366 | Clara A Matthews | Physician Assistant | 1930 Windsor Creek Drive Sw, Conyers, GA 30094 | 2019-12-18 |
| 1659838571 | Sensitive Home Care Agency Inc. | PACE Provider Organization | 2225 Morning Dew, Conyers, GA 30094 | 2019-02-27 |
| 1679097992 | Sheira Dennis | Case Management | 3828 Martingale Dr Se, Conyers, GA 30094 | 2017-07-28 |
| 1730571399 | Wellness and Trauma Recovery Center | Counselor | 1775 Parker Rd. Building C, Suite 210, Conyers, GA 30094 | 2015-02-19 |
| 1760870612 | Michael Terrell | Technician/Technologist | 806 Cambridge Creek Dr, Conyers, GA 30094 | 2014-12-30 |
| 1538567466 | Jennifer Angela Johnson | Registered Nurse | 2240 Wren Rd Se, Conyers, GA 30094 | 2014-12-09 |
| 1225445208 | Wanda Marcella Rainey-reed | Counselor | 1453 Klondike Rd Sw Ste D, Conyers, GA 30094 | 2014-07-22 |
| 1508155268 | Nicklaus Trent Rice | Obstetrics & Gynecology | 2750 Owens Dr, Conyers, GA 30094 | 2011-04-04 |
| 1720219660 | Candace Alexander | Dentist | 863 Flat Shoals Rd Se, Suite C #220, Conyers, GA 30094 | 2009-07-27 |
| Find all providers in zip 30094 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649631037 | Foot and Ankle Institute of Georgia | Podiatrist | 1815 Highway 138 Se # Sr, Suite 600, Conyers, GA 30013-2079 | 2016-03-11 |
| 1356323778 | James Edwin Williams Jr. | Podiatrist | 1025 E Freeway Dr Se, Conyers, GA 30094-5965 | 2005-11-20 |
| 1700885910 | Gerald Wayne Newman Jr. | Podiatrist | 1567 Milstead Rd Ne, Suite A, Conyers, GA 30012-3835 | 2005-07-19 |
| 1447254131 | Ketan B Patel | Podiatrist | 1720 Honey Creek Commons, Ste B, Conyers, GA 30013-5826 | 2005-06-09 |
| 1285186452 | Shadae Mcmillan | Podiatrist | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2016-11-03 |
| 1164812202 | Alvin Jeffrey Cowans II | Podiatrist | 1025 E Freeway Dr Se, Conyers, GA 30094-5965 | 2015-01-28 |
| 1760802268 | Darrice Collins | Podiatrist | 1025 E Freeway Dr Se, Conyers, GA 30094 | 2014-04-23 |
| 1639478407 | Adrianne J Ross | Podiatrist | 1815 Highway 138 Se, Suite 600, Conyers, GA 30013-2079 | 2011-03-19 |
| 1063697951 | Ankle and Foot Specialists of Rockdale | Podiatrist | 1025 E Freeway Dr Se, Conyers, GA 30094-5965 | 2008-01-09 |
| 1932393253 | Associated Foot & Ankle Specialists, P.C. | Podiatrist | 1567 Milstead Rd Ne, Suite A, Conyers, GA 30012-3835 | 2007-08-29 |
| Find all providers in CONYERS | ||||
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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.