MR. MARK A RISEN (NPI# 1174571004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174571004 |
| Entity Type | Individual |
| Full Name | MR. MARK A RISEN |
| Credential | DPM |
| Practice Address |
1003 Old Greensburg Rd Campbellsville KY 42718-2571 |
| Mailing Address |
1003 Old Greensburg Rd. Campbellsville KY 42718 |
| Practice Telephone | (270) 433-5806 |
| Practice Fax Number | 2704332443 |
| Mailing Telephone | 2704335806 |
| Mailing Fax Number | 2704332443 |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2018-06-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213E00000X | Podiatrist | 00216 | KY | Podiatric Medicine & Surgery Service Providers |
| Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
00216 | KY | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 80002165 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 138 Campbellsville Byp, Campbellsville, KY 427188843 | 2704335806 | 2704332443 |
| Street Address |
1003 OLD GREENSBURG RD |
| City | CAMPBELLSVILLE |
| State | KY |
| Zip Code | 42718-2571 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154346948 | Mark A Risen, Dpm | Durable Medical Equipment & Medical Supplies | 1003 Old Greensburg Rd, Campbellsville, KY 42718-2571 | 2006-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619417763 | Heather Hastings | Dentist | 2065 Meadow Creek Rd, Campbellsville, KY 42718 | 2017-03-07 |
| 1487101804 | Amanda Rose Shepperd | Nurse Practitioner | 1846-1856 Old Lebanon Rd, Campbellsville, KY 42718 | 2016-09-01 |
| 1841660305 | Forefront Dermatology, S.c. | Dermatology | 105 Medical Park Dr Ste 1, Campbellsville, KY 42718 | 2015-09-28 |
| 1154790616 | Viktoria Krell | Counselor | 3020 Old Lebanon Road, Campbellsville, KY 42718 | 2015-09-15 |
| 1679977649 | Joy Trotter | Occupational Therapist | 121a Casey Street, Campbellsville, KY 42718 | 2014-10-20 |
| 1083022727 | Taylor Regional Medical Group, LLC | Physical Therapist | 73 Kingswood Dr Ste B, Campbellsville, KY 42718 | 2014-07-25 |
| 1235574831 | Rachael Maia Yates | Clinical Neuropsychologist | 50 Gene Cash Road, Campbellsville, KY 42718 | 2013-05-08 |
| 1255536579 | Elizabethtown Physical Therapy Psc | Clinic/Center | 315 East Broadway, Campbellsville, KY 42718 | 2007-06-18 |
| 1508900283 | Lake Cumberland District Health Department | Public Health or Welfare | 1880 N Bypass Road, Campbellsville, KY 42718 | 2007-02-16 |
| 1871639005 | Joseph William Segree | Optometrist | 725 Campbellsville Bypass, Campbellsville, KY 42718 | 2007-01-29 |
| Find all providers in zip 42718 | ||||
| Taxonomy Code | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811421076 | Christian Eric Ball | Podiatrist | 108 Cardinal Dr, Central City, KY 42330-1728 | 2017-04-14 |
| 1225183452 | Lee H. Goldstein Dpm Psc | Podiatrist | 509 E 18th St, Owensboro, KY 42303-3849 | 2007-01-25 |
| 1831182435 | Christopher W Hubbard | Podiatrist | 1905 W Hebron Ln, Shepherdsville, KY 40165-7465 | 2005-08-30 |
| 1982176657 | C B Podiatric Services, Pllc | Podiatrist | 108 Cardinal Dr, Central City, KY 42330-1728 | 2018-12-19 |
| 1053579532 | James B Braudis Dpm Plc | Podiatrist | 1236 Gainesway Dr, Lexington, KY 40517-2813 | 2008-05-30 |
| 1265431845 | Charles J Sugarman | Podiatrist | 525 Alexandria Pike, Suite 230, Southgate, KY 41071-3290 | 2005-07-18 |
| 1174521082 | William M Nielson | Podiatrist | 7370 Turfway Rd, Ste 302, Florence, KY 41042 | 2005-07-13 |
| City | CAMPBELLSVILLE |
| Zip Code | 42718 |
Please comment or provide details below to improve the information on MR. MARK A RISEN.
| 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.