BROADWAY FOOT CLINIC CORPORATION (NPI# 1073510244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073510244 |
| Entity Type | Organization |
| Organization Name | BROADWAY FOOT CLINIC CORPORATION |
| Practice Address |
3290 Grant St Suite 108 Gary IN 46408-1015 |
| Practice Telephone | 2198847880 |
| Practice Fax Number | 2198847880 |
| Mailing Telephone | 2198847880 |
| Mailing Fax Number | 2198847880 |
| Enumeration Date | 2005-07-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. SONNY O OJIKUTU (VICE PRESIDENT) |
| Authorized Official Telephone | 2198847880 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 07000445A | IN | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 10058560 | 05 |
| Street Address |
3290 GRANT ST SUITE 108 |
| City | GARY |
| State | IN |
| Zip Code | 46408-1015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205180676 | Fresenius Medical Care Nw Indiana, LLC | Clinic/Center | 3290 Grant St, Gary, IN 46408-1015 | 2012-11-06 |
| 1194830935 | Everest Healthcare Indiana, Inc. | Clinic/Center | 3290 Grant St, Gary, IN 46408-1015 | 2006-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497275788 | Brynn T Shelton | Home Health Aide | 4138 Ruthledge St, Gary, IN 46408 | 2017-06-27 |
| 1306243027 | Around The Clock Transportation | Non-emergency Medical Transport (VAN) | 3979 Cleveland St, Gary, IN 46408 | 2014-11-24 |
| 1710900956 | Home Health Services Inc | Home Health | 1281 W Ridge Road, Gary, IN 46408 | 2006-07-26 |
| 1023031978 | Nkechi Pauline Onyeukwu | Nurse Practitioner | 3814 Grant Street, Gary, IN 46408 | 2006-07-25 |
| 1093724007 | Geoffrey Okechukwu Onyeukwu | Family Medicine | 3814 Grant Street, Gary, IN 46408 | 2006-08-07 |
| 1629091863 | Home Health Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 1281 W Ridge Road, Gary, IN 46408 | 2006-07-26 |
| 1952364648 | Trc - Indiana LLC | Clinic/Center | 4802 Broadway, Gary, IN 46408 | 2006-04-11 |
| 1912067349 | Indiana University Northwest | Dentist | 3400 Broadway, Gary, IN 46408-1101 | 2006-12-08 |
| 1669742565 | Stephanie Lynn Smith | Specialist/Technologist | 3400 Broadway, Savannah Center 217, Gary, IN 46408-1101 | 2012-01-09 |
| 1235399726 | Northwest Center Medical Services Corp | Medical Genetics | 3400 Broadway, Gary, IN 46408-1101 | 2008-06-10 |
| Find all providers in zip 46408 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386685139 | Lashawn Freeman | Podiatrist | 650 Grant St, Suite 4, Gary, IN 46404-1533 | 2006-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003472721 | Roman Podiatry Partners Inc | Podiatrist | 2308 N. Roosevelt, Valparaiso, IN 46383 | 2019-05-17 |
| 1770040081 | Apex Podiatry, Inc. | Podiatrist | 1720 Lafayette Rd Ste 3, Crawfordsville, IN 47933-4604 | 2019-02-22 |
| 1982176913 | A-warnock LLC | Podiatrist | 1103 Central Park Blvd N, Greenwood, IN 46143-7312 | 2019-01-02 |
| 1336658095 | Jenkins Podiatry PC | Podiatrist | 3310 Highway 62 East, Suite 179, Jeffersonville, IN 47130 | 2017-09-26 |
| 1629592191 | Christie Foot & Ankle, LLC | Podiatrist | 3031 Meridian Meadows Rd, Greenwood, IN 46142-1011 | 2017-07-27 |
| 1154842896 | Major Multispecialty Associates | Podiatrist | 30 W Rampart St Ste 180, Shelbyville, IN 46176-8845 | 2017-07-03 |
| 1336677046 | John Paul Bonvillian | Podiatrist | Major Hospital, 2451 Intelliplex Dr, Shelbyville, IN 46176 | 2017-05-24 |
| 1538693536 | Nicholas Nicholas Lalios | Podiatrist | 7800 Madison St, Merrillville, IN 46410-4615 | 2017-04-17 |
| 1558713354 | Allegiant Podiatry, Inc. | Podiatrist | 515 Silhavy Rd, Apt # 2, Valparaiso, IN 46383-4452 | 2016-07-06 |
| 1275984643 | Jordan Gardner | Podiatrist | 3801 Bellemeade Ave Ste 110, Evansville, IN 47714-0111 | 2016-06-28 |
| 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.