SOUTHEASTERN FOOT & ANKLE ASSOCIATES, PA (NPI# 1154450393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1154450393 |
Entity Type | Organization |
Organization Name | SOUTHEASTERN FOOT & ANKLE ASSOCIATES, PA |
Practice Address |
920 S 17th St Wilmington NC 28401-8022 |
Practice Telephone | 9107637578 |
Practice Fax Number | 9107639320 |
Mailing Telephone | 9107637578 |
Mailing Fax Number | 9107639320 |
Enumeration Date | 2007-03-05 |
Last Update Date | 2013-08-30 |
Authorized Official Name | DR. ROBERT MCCONEKEY (OWNER) |
Authorized Official Telephone | 9107637578 |
Authorized Official Credential | DPM |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP1100X |
Clinic/Center Specialization: Podiatric |
465 | NC | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | MEDICARE PTAN | 2332798 | 01 |
NC | 890808U | 05 |
Street Address |
920 S 17TH ST |
City | WILMINGTON |
State | NC |
Zip Code | 28401-8022 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710943212 | Robert Mcconekey | Podiatrist | 920 S 17th St, Wilmington, NC 28401-8022 | 2006-04-24 |
1801074588 | Carine Khouri | Podiatrist | 920 S 17th St, Wilmington, NC 28401-8022 | 2008-02-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275002461 | Thrivetothrive, LLC | Physical Therapist | 1606 Physicians Drive, Inside Promina Health, Wilmington, NC 28401 | 2018-11-16 |
1841787454 | Kevin Christopher Panebianco | Family Medicine | 1911 S 17th St Ste 130a, Wilmington, NC 28401 | 2018-04-18 |
1518472588 | Michelle Bruin | Family Medicine | 415 S. 2nd Street, Wilmington, NC 28401 | 2017-12-12 |
1639617343 | Anna Farwell | Behavior Technician | 3904 Oleander Dr. Suite 102, Wilmington, NC 28401 | 2017-02-02 |
1588034144 | Dimitri Zivko Pitovski | Allergy & Immunology | 1099 Medical Center Dr Unit 100b, Wilmington, NC 28401 | 2015-09-25 |
1629457007 | Megan Havel | Counselor | 1512 E Lakeshore Drive, Wilmington, NC 28401 | 2015-05-19 |
1154709251 | Lance Hutchens | Dentist | 1611 Doctors Cir, Wilmington, NC 28401 | 2015-05-11 |
1609281161 | Diane Pittman Whitford | Counselor | 313 Walnut St., Wilmington, NC 28401 | 2014-06-24 |
1942550728 | Bryan Cole Chalk | Nurse Anesthetist, Certified Registered | 2131 S 17th Street, Wilmington, NC 28401 | 2012-09-19 |
1740566546 | Valerie Baars | Pharmacist | 2302 S 17th Street, Wilmington, NC 28401 | 2011-10-25 |
Find all providers in zip 28401 |
Taxonomy Code | 261QP1100X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Podiatric |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659898039 | Noah Foot and Ankle Center, Pllc | Clinic/Center | 5226 S College Rd Ste 4, Wilmington, NC 28412-2236 | 2017-08-25 |
1083847644 | Michael R Haag, Dpm, Atc, LLC | Clinic/Center | 5311 Limestone Rd, Suite 203, Wilmington, DE 19808-1246 | 2009-08-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083258115 | Catawba Valley Medical Group Inc | Clinic/Center | 1985 Startown Rd Ste 101, Hickory, NC 28602-8307 | 2019-11-01 |
1346730173 | Coastal Foot Center, LLC | Clinic/Center | 29 Office Park Dr Ste B, Jacksonville, NC 28546 | 2018-05-17 |
1922296243 | Foot Care Associates, LLP | Clinic/Center | 1470 Rymco Drive, Winston-salem, NC 27103-2944 | 2007-10-11 |
1386919181 | Alta Ridge Foot Specialists, Pllc | Clinic/Center | 105 Chestnut St, Mars Hill, NC 28754-9602 | 2012-03-13 |
1871808782 | Family Foot Care Assoc. P.a. | Clinic/Center | 4286 Raeford Rd, Fayetteville, NC 28304-3247 | 2010-08-16 |
1891935821 | Alta Ridge Foot Specialists Pllc | Clinic/Center | 537 Altapass Hwy, Spruce Pine, NC 28777-3012 | 2009-03-03 |
1598924599 | Mt Airy Foot and Ankle Center Pllc | Clinic/Center | 1908 Caudle Dr, Suite 103, Mount Airy, NC 27030-4312 | 2008-06-04 |
1194990994 | Uwharrie Podiatry, LLC | Clinic/Center | 143 N 3rd St, Albemarle, NC 28001-4901 | 2008-04-23 |
1962673640 | Uwharrie Podiatry, LLC | Clinic/Center | 143 N 3rd St, Albemarle, NC 28001-4901 | 2008-03-20 |
1336327659 | Ankle & Foot Center of Charlotte Pllc | Clinic/Center | 12610 N Community House Rd, Suite 202, Charlotte, NC 28277 | 2008-02-08 |
Find all providers with the same taxonomy |
City | WILMINGTON |
Zip Code | 28401 |
Please comment or provide details below to improve the information on SOUTHEASTERN FOOT & ANKLE ASSOCIATES, PA.
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.