MR. ROGER PETER THEODORE (NPI# 1154398402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154398402 |
| Entity Type | Individual |
| Full Name | MR. ROGER PETER THEODORE |
| Credential | DPM |
| Practice Address |
841 Mulberry St Macon GA 31201 |
| Practice Telephone | 4787411192 |
| Practice Fax Number | 4787410029 |
| Mailing Telephone | 4787411192 |
| Mailing Fax Number | 4787410029 |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2008-05-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 000753 | GA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE | 480025693 | 01 | |
| GA | 00655322A | 05 | |
| RAILROAD MEDICARE | 480018494 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306841614 | Roger Theodore | Physical Medicine & Rehabilitation | 1001 Cromwell Bridge Rd, Suite 200, Towson, MD 21286-3300 | 2005-06-15 |
| Street Address |
841 MULBERRY ST |
| City | MACON |
| State | GA |
| Zip Code | 31201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861034415 | Jacquita Nicole Baker Baldwin | Nurse Practitioner | 841 Mulberry St, Macon, GA 31201-6756 | 2019-10-16 |
| 1770042228 | Andrrea Michelle Zellner | Nurse Practitioner | 841 Mulberry St, Macon, GA 31201-6756 | 2019-03-14 |
| 1104298900 | Dorothy Bre'anna D Thomas | Nurse Practitioner | 841 Mulberry St, Macon, GA 31201-6756 | 2015-10-20 |
| 1306183280 | Family Foot and Ankle Center | Podiatrist | 841 Mulberry St, Macon, GA 31201-6756 | 2013-01-11 |
| 1922238047 | S.e. Family Foot & Ankle Center LLC | Podiatrist | 841 Mulberry St, Macon, GA 31201-6756 | 2009-07-23 |
| 1992966790 | American Home Care & Medical Services | Nursing Care | 841 Mulberry St, Macon, GA 31201-6756 | 2008-06-24 |
| 1265638381 | S.dekalb Foot & Ankle Surgical Ctr | Clinic/Center | 841 Mulberry St, Macon, GA 31201-6756 | 2007-06-25 |
| 1417178187 | Clyde O. Green | Family Medicine | 841 Mulberry St, Macon, GA 31201-6756 | 2007-05-01 |
| 1124152459 | Family Foot and Ankle Ctr | Podiatrist | 841 Mulberry St, Macon, GA 31201-6756 | 2007-03-16 |
| 1528125648 | Infinity Laboratory | Clinical Medical Laboratory | 841 Mulberry St, Macon, GA 31201-6756 | 2007-01-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639666340 | Yasameen Emad Muzahim | Internal Medicine | 777 Hemlock Street, Msc 165, Macon, GA 31201 | 2018-04-18 |
| 1952819419 | Putnam Dialysis LLC | Clinic/Center | 657 Hemlock Street, Suite 200, Macon, GA 31201 | 2018-01-18 |
| 1730604331 | Graham Arthur Mercier | Surgery | 169 Ashley Ave., Room 202 Main Hospital Msc 333, Charleston, SC 31201 | 2017-08-04 |
| 1376075705 | Diamond Jude | Internal Medicine | 777 Hemlock Street Msc #104, Macon, GA 31201 | 2017-04-03 |
| 1174055263 | Carol Roobin Bashuk | Hearing Instrument Specialist | 634 First Street, Macon, GA 31201 | 2017-03-29 |
| 1144752411 | Hubert Pare | Student in an Organized Health Care Education/Training Program | 777 Hemlock Street, Msc# 165, Macon, GA 31201 | 2017-03-28 |
| 1548613789 | Michael Daugherty | Counselor | 1873 Hardeman Ave, Suite 1, Macon, GA 31201 | 2016-07-22 |
| 1316317993 | 4front Healthcare of Middle Georgia, LLC | Hospice Care, Community Based | 682 1st St, Macon, GA 31201 | 2015-09-25 |
| 1881073054 | Andrew Lee Drahos | Surgery | 777 Hemlock St # 140, Macon, GA 31201 | 2015-05-21 |
| 1720474158 | April Nicole Colley | Nurse Practitioner | 1014 Forsyth Street, Macon, GA 31201 | 2015-04-13 |
| Find all providers in zip 31201 | ||||
| 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 |
|---|---|---|---|---|
| 1700440401 | Pamela Onderko Dpm LLC | Podiatrist | 5223 Riverside Dr Ste 104, Macon, GA 31210-0889 | 2019-04-28 |
| 1083842637 | Irma Wejuli | Podiatrist | 6416 Peake Road, #18, Macon, GA 31210 | 2009-06-22 |
| 1437396447 | Village Podiatry Group, LLC. | Podiatrist | 3556 Riverside Drive, Macon, GA 31210-2509 | 2009-01-13 |
| 1104015189 | Family Foot Clinic | Podiatrist | 1501 N Missouri St, Macon, MO 63552-1969 | 2007-10-16 |
| 1104832484 | Katanga Mccoy | Podiatrist | 940 Pio Nono Ave, Macon, GA 31204-4059 | 2006-07-31 |
| 1780602011 | Consuela Maria Williams-holliday | Podiatrist | 440 Charter Blvd, Ste 2202, Macon, GA 31210-0705 | 2006-07-17 |
| 1114901956 | Joseph Michael Union | Podiatrist | 2180 Vineville Ave, Macon, GA 31204-3124 | 2005-12-05 |
| 1437150117 | Keith Alan Beauchamp | Podiatrist | 106 Butler St, Suite A, Macon, MO 63552-1629 | 2005-08-03 |
| 1366796930 | Village Podiatry Group, LLC | Podiatrist | 770 Pine St, Ste 300, Macon, GA 31201-2173 | 2012-11-05 |
| 1922238047 | S.e. Family Foot & Ankle Center LLC | Podiatrist | 841 Mulberry St, Macon, GA 31201-6756 | 2009-07-23 |
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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.