PROVIDENCE FOOT & ANKLE CENTERS, PC, INC (NPI# 1083972376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083972376 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE FOOT & ANKLE CENTERS, PC, INC |
| Practice Address |
4109 Jimmy Lee Smith Pkwy Suite C Hiram GA 30141-2643 |
| Mailing Address |
3886 Princeton Lakes Way Sw Suite 140a Atlanta GA 30331-5511 |
| Practice Telephone | 7707454224 |
| Practice Fax Number | 7707454228 |
| Mailing Telephone | 7707454224 |
| Mailing Fax Number | 7707454228 |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2012-04-25 |
| Authorized Official Name | DR. ADRIENNE M. ATKINSON-SNEED (CEO) |
| Authorized Official Telephone | 2157407000 |
| Authorized Official Credential | D.P.M. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers | ||
| N | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
Podiatric Medicine & Surgery Service Providers | ||
| N | 213ER0200X |
Podiatrist Specialization: Radiology |
Podiatric Medicine & Surgery Service Providers | ||
| N | 213ES0000X |
Podiatrist Specialization: Sports Medicine |
Podiatric Medicine & Surgery Service Providers | ||
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | MEDICARE GROUP PTAN GEORGIA | 511G700902 | 01 |
| GA | RR MEDICARE GROUP NUMBER GEORGIA | DQ9092 | 01 |
| Street Address |
4109 JIMMY LEE SMITH PKWY SUITE C |
| City | HIRAM |
| State | GA |
| Zip Code | 30141-2643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801255690 | Belinda Lett Baker | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5316 Jones Reserve Walk, Hiram, GA 30141 | 2016-02-22 |
| 1104213339 | Matthew Lee Estes | Nurse Practitioner | 148 Bill Carruth Pkwy Ste 220, Hiram, GA 30141 | 2015-04-26 |
| 1881088649 | Marietta Eye Clinic, Pa | Optometrist | 47 Highland Pavilion Ct, Suite 101, Hiram, GA 30141 | 2015-03-19 |
| 1902217417 | Hiram Dental Group, PC | Dentist | 5218 Jimmy Lee Smith Parkway, Suite 100, Hiram, GA 30141 | 2014-05-19 |
| 1912340613 | Anuj Patel | Orthopaedic Surgery | 148 Bill Carruth Parkway Suite 120, Hiram, GA 30141 | 2013-04-11 |
| 1619280278 | Thomas Wayne Bloodworth | Obstetrics & Gynecology | 6794 Bill Carruth Parkway, Hiram, GA 30141 | 2010-07-23 |
| 1487970026 | Madelynn Lorraine Speach | Counselor | 44 Darbys Crossing Dr Ste 206c, Hiram, GA 30141 | 2010-04-07 |
| 1679760433 | We Care Md, P.C. | Family Medicine | 5610 Wendy Bagwell Parkway, Suite 103, Hiram, GA 30141 | 2007-09-26 |
| 1811188121 | Holly L Watson | Nurse Practitioner | 156 Hiram Drive, Building B, Hiram, GA 30141 | 2007-08-05 |
| 1285842799 | Restoration Physical Therapy, LLC. | Clinic/Center | 5077 Jimmy Lee Smith Pkwy, Suite 119, Hiram, GA 30141 | 2007-05-18 |
| Find all providers in zip 30141 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518515980 | Da Vinci Foot and Ankle Madison LLC | Podiatrist | 1740 Lions Club Rd Ste 200, Madison, GA 30650-4762 | 2019-08-29 |
| 1376191106 | Ryan Goldfine Dpm LLC | Podiatrist | 3451 Ernest W Barrett Pkwy Suite 170, Mariettta, GA 30269 | 2019-08-26 |
| 1073076170 | Kalish Foot & Ankle Institute | Podiatrist | 6911 Tara Blvd Ste 101, Jonesboro, GA 30236-1503 | 2019-04-08 |
| 1427523919 | Tommy Lee Tally | Podiatrist | 8225 Mall Pkwy Ste 230, Lithonia, GA 30038-6913 | 2018-10-10 |
| 1881188944 | Joshua Jae Lee | Podiatrist | 3425 Buford Dr Ste 350, Buford, GA 30519-8785 | 2018-06-21 |
| 1437652815 | Southeast Regional Primary Care Corporation | Podiatrist | 1707 Meadows Ln Ste H, Vidalia, GA 30474-7201 | 2018-03-13 |
| 1447762927 | Ponders Podiatry LLC | Podiatrist | 275 Carpenter Drive Ne, Suite 106, Atlanta, GA 30328 | 2017-10-24 |
| 1194245894 | Yusuf Abiodun Opakunle | Podiatrist | 600 Professional Dr Ste 130, Lawrenceville, GA 30046-7638 | 2017-06-23 |
| 1891228540 | Vishal Patel | Podiatrist | 755 Mount Vernon Hwy Ne Ste 210, Atlanta, GA 30328-4279 | 2017-04-10 |
| 1497296552 | Ankle and Foot Assoc, LLC | Podiatrist | 118 Azalea Rd, Suite 1-2, Baxley, GA 31513-0672 | 2017-03-09 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PROVIDENCE FOOT & ANKLE CENTERS, PC, INC.
| 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.