RIVER HEALTH CARE, LLC (NPI# 1184009086) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184009086 |
| Entity Type | Organization |
| Organization Name | RIVER HEALTH CARE, LLC |
| Other Organization Name | MAGNOLIA FOOT CARE CENTER |
| Practice Address |
426 Abbey Woods Brandon MS 39047-7719 |
| Mailing Address |
4510 Office Park Dr Jackson MS 39206-6016 |
| Practice Telephone | 6019416386 |
| Mailing Telephone | 6019416386 |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2015-07-21 |
| Authorized Official Name | LARRY K CRUEL (OWNER / PRESIDENT) |
| Authorized Official Telephone | 6019416386 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | Y |
| Parent Organization Name | RIVER HEALTH CARE, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 80152 | MS | Podiatric Medicine & Surgery Service Providers |
| Other Name | Type Code |
|---|---|
| Magnolia Foot Care Center | Doing Business As Name - Organization |
| Street Address |
426 ABBEY WOODS |
| City | BRANDON |
| State | MS |
| Zip Code | 39047-7719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396368783 | Siyuan Chen Kennedy | Counselor | 108 Sandstone Drive, Brandon, MS 39047 | 2020-05-20 |
| 1568019784 | Juarez Brown Emerson | Registered Nurse | 426 Pinebrook Circle, Brandon, MS 39047 | 2019-08-22 |
| 1649764127 | Specialty Diagnostics LLC | Family Medicine | 1149 Old Fannin Rd Ste 22, Brandon, MS 39047 | 2018-06-19 |
| 1528423035 | Kathlene Strangeman | Social Worker | 111 Lakeshore Dr Apt G403, Brandon, MS 39047 | 2015-12-28 |
| 1174935076 | Anthony Davis | Counselor | 198 Bellegrove Cir, Brandon, MS 39047 | 2014-05-27 |
| 1144659178 | Medical Foundation of Central Ms, Inc | Family Medicine | 1887 Spillway Rd., Brandon, MS 39047 | 2013-11-12 |
| 1437429941 | Picton Timothy Evans | Pharmacist | 150 B Cumberland Ed, Brandon, MS 39047 | 2012-01-01 |
| 1275828030 | Kathryn Audell Piburn | Nurse Practitioner | 1887 Spillway Rd Ste 140, Brandon, MS 39047 | 2011-06-09 |
| 1801930532 | Susanne Reynolds Moore | Dentist | 1149 Old Fannin Rd, Suite 26, Brandon, MS 39047 | 2007-02-16 |
| 1194898429 | Brookshire Grocery Company | Durable Medical Equipment & Medical Supplies | 143 Plaza Drive Ext, Attention Pharmacy Dept, Brandon, MS 39047 | 2006-11-16 |
| Find all providers in zip 39047 | ||||
| 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 |
|---|---|---|---|---|
| 1366600959 | Mark G Leitner Dpm | Podiatrist | 132 S Moon Ave, Brandon, FL 33511-5110 | 2008-05-30 |
| 1104833318 | Linda Jane Palmer | Podiatrist | 1149 Professional Park Dr, Brandon, FL 33511-4887 | 2006-08-01 |
| 1043262173 | John V Tran Dpm Mph Pa | Podiatrist | 1462 Oakfield Dr, Brandon, FL 33511-4853 | 2006-05-17 |
| 1811959729 | John Van Tran | Podiatrist | 505 Eichenfeld Dr, Suite 108, Brandon, FL 33511-5985 | 2006-04-05 |
| 1629044870 | Vincent G Crump | Podiatrist | 1735 Brandon Trace Ave, Brandon, FL 33510-2027 | 2006-02-27 |
| 1962401067 | Mark G Leitner | Podiatrist | 206 Buckingham Pl, Suite 101, Brandon, FL 33511-4910 | 2005-07-20 |
| 1942209929 | Larry A Kaler | Podiatrist | 669a W Lumsden Rd Ste A, Brandon, FL 33511-5911 | 2005-07-20 |
| 1437505179 | Patrick Donovan | Podiatrist | 615 Vonderburg Dr, Brandon, FL 33511 | 2016-05-12 |
| 1215168521 | Baha Aldean Atway | Podiatrist | 505 Eichenfeld Dr, Suite 108, Brandon, FL 33511-5985 | 2009-08-04 |
| 1265663777 | Kristi L Conway Dpm Pa | Podiatrist | 1149 Professional Park Dr, Brandon, FL 33511-4887 | 2009-07-31 |
| Find all providers in BRANDON | ||||
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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.