EAST VALLEY FOOTCARE PLLC (NPI# 1184737546) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184737546 |
| Entity Type | Organization |
| Organization Name | EAST VALLEY FOOTCARE PLLC |
| Practice Address |
6104 E Brown Rd Suite 102 Mesa AZ 85205-4953 |
| Practice Telephone | 4803574400 |
| Practice Fax Number | 4808070800 |
| Mailing Telephone | 4803574400 |
| Mailing Fax Number | 4808070800 |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2013-04-23 |
| Authorized Official Name | CHARLES CONNELL (PRESIDENT) |
| Authorized Official Telephone | 4803574400 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 322 | AZ | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | RR MEDICARE | 480032936 | 01 |
| AZ | RAILROAD MEDICARE | 480032937 | 01 |
| Street Address |
6104 E BROWN RD SUITE 102 |
| City | MESA |
| State | AZ |
| Zip Code | 85205-4953 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992791313 | Charles Connell | Podiatrist | 6104 E Brown Rd, Mesa, AZ 85205-4953 | 2005-09-21 |
| 1255533097 | Laurel A. Retay Do, Plc | Internal Medicine | 6104 E Brown Rd, Suite 101, Mesa, AZ 85205-4953 | 2007-06-04 |
| 1346236544 | Jeffrey Pawlowski | Podiatrist | 6104 E Brown Rd, Suite 101, Mesa, AZ 85205-4953 | 2005-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083130199 | Rose Campbell | Technician/Technologist | 649 North Orlando, Mesa, AZ 85205 | 2017-08-21 |
| 1528459781 | Elizabeth Sadler | Nurse Practitioner | 4434 E Brown Rd Ste 102, Mesa, AZ 85205 | 2015-02-10 |
| 1326444324 | Katherine G Perez | Counselor | 152 N Power Rd Ste 2, Mesa, AZ 85205 | 2014-11-18 |
| 1831500800 | C.b.o Hearing | Hearing Aid Equipment | 4406 E. Main St, Suite 103, Mesa, AZ 85205 | 2014-05-13 |
| 1699195107 | Amanda Mcdaniel | Occupational Therapist | 5911 E. Fountain St., Mesa, AZ 85205 | 2014-04-23 |
| 1952640278 | Medstar Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 3932 E Fairfield Cir, Mesa, AZ 85205 | 2013-02-06 |
| 1245575398 | Fabulous Smiles of Mesa | Dentist | 4434 E. Brown Rd, Ste 104, Mesa, AZ 85205 | 2012-11-30 |
| 1992087639 | Matthew Robert Millward | Pharmacist | 1935 N. Power Rd, Mesa, AZ 85205 | 2011-09-19 |
| 1740596733 | Arizona Family & Geriatric Medicine Pllc | Clinic/Center | 5602 E. Main St., Mesa, AZ 85205 | 2010-08-27 |
| 1295049609 | Thomas Chambers | Podiatrist | 5520 E Main St Ste 2, Mesa, AZ 85205 | 2010-07-28 |
| Find all providers in zip 85205 | ||||
| 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 |
|---|---|---|---|---|
| 1295049609 | Thomas Chambers | Podiatrist | 5520 E Main St Ste 2, Mesa, AZ 85205 | 2010-07-28 |
| 1083685341 | John W. Fiorino | Podiatrist | 5520 E Main St, Suite 2, Mesa, AZ 85205-8793 | 2006-01-26 |
| 1669442448 | Donald Siegel | Podiatrist | 2919 S Ellsworth Rd Ste 124, Mesa, AZ 85212-2167 | 2006-01-25 |
| 1538139449 | Kimberly A Leach | Podiatrist | 1620 S Stapley Dr, #132, Mesa, AZ 85204 | 2006-01-24 |
| 1144218314 | Bjorn Lawson | Podiatrist | 1121 S Gilbert Rd, Suite 102, Mesa, AZ 85204-5235 | 2005-10-11 |
| 1376198325 | Arizona Preferred Podiatry Management, LLC | Podiatrist | 2919 S Ellsworth Rd Ste 124, Mesa, AZ 85212-2167 | 2019-08-07 |
| 1558702399 | Dean B Clement, Dpm, Pllc | Podiatrist | 5520 E Main St, #2, Mesa, AZ 85205-8793 | 2013-07-09 |
| 1528355708 | David T Ellsworth | Podiatrist | 4121 E Valley Auto Dr, Ste 110, Mesa, AZ 85206-4632 | 2011-07-07 |
| 1871898288 | Arizona Foot and Ankle Medicine and Surgery, Plc | Podiatrist | 1347 N Greenfield Rd, Suite 101, Mesa, AZ 85205-4072 | 2011-01-14 |
| 1417129248 | Gregg Krahn Dpm PC | Podiatrist | 1301 S Crismon Rd, Mesa, AZ 85209-3767 | 2008-04-01 |
| Find all providers in MESA | ||||
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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.