RICHARD FELIX WITTOCK III (NPI# 1215943105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215943105 |
| Entity Type | Individual |
| Full Name | RICHARD FELIX WITTOCK III |
| Credential | D.P.M. |
| Practice Address |
1011 Bowles Avenue Suite 123 Fenton MO 63026 |
| Practice Telephone | 6367171100 |
| Practice Fax Number | 6367171113 |
| Mailing Telephone | 6367171100 |
| Mailing Fax Number | 6367171113 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2009-09-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 2002003866 | MO | Podiatric Medicine & Surgery Service Providers |
| Street Address |
1011 BOWLES AVENUE SUITE 123 |
| City | FENTON |
| State | MO |
| Zip Code | 63026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104872068 | Timothy James Pratt | Internal Medicine | 1011 Bowles Avenue, Suite 121, Fenton, MO 63026 | 2006-05-25 |
| 1073903134 | Anastasia A Averbukh | Nurse Practitioner | 1011 Bowles Avenue, Suite 121, Fenton, MO 63026-2387 | 2015-01-28 |
| 1760810543 | St Louis Dermatology LLC | Dermatology | 1011 Bowles Avenue, Suite 121, Fenton, MO 63026-2387 | 2013-10-14 |
| 1831335819 | Ankle and Foot Institute of Missouri P.C. | Podiatrist | 1011 Bowles Avenue, Suite 123, Fenton, MO 63026 | 2008-12-23 |
| 1871617993 | Allison K Davis | Surgery | 1011 Bowles Avenue, Suite 425, Fenton, MO 63026 | 2007-03-16 |
| 1124046354 | Edward Reh | Internal Medicine | 1011 Bowles Avenue, Suite 300, Fenton, MO 63026-2387 | 2006-07-17 |
| 1295768323 | Douglas Dripps | Internal Medicine | 1011 Bowles Avenue, Suite 300, Fenton, MO 63026-2387 | 2006-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871000372 | Allison Egler | Audiologist | 1011 Bowles Ave Ste 405, Fenton, MO 63026 | 2018-01-05 |
| 1629508213 | Holly Brooks Munson | Massage Therapist | 220 Copper Mountain Dr, Fenton, MO 63026 | 2017-06-15 |
| 1073978862 | Naomi Sharon | Nurse Practitioner | 1101 Bowles Avenue, Suite G50, Fenton, MO 63026 | 2015-12-21 |
| 1871981704 | Celtic Private Care of Il & Mo, LLC | In Home Supportive Care | 1653 Larkin Williams Road, Suite 201, Fenton, MO 63026 | 2014-12-30 |
| 1356747513 | Kristina Potts | Nurse Practitioner | 774 Gravois Bluffs Blvd Ste B, Fenton, MO 63026 | 2014-11-14 |
| 1245642420 | Physicians Health Group Medical Inc | General Practice | 960 S. Highway Dr, Fenton, MO 63026 | 2014-05-22 |
| 1598047409 | Kevin Eugene Bruce | Pharmacist | 1210 Sugar Creek, Fenton, MO 63026 | 2011-09-16 |
| 1215186382 | Concentra Health Services, Inc. | Clinic/Center | 128 Matrix Commons Dr., Fenton, MO 63026 | 2008-09-15 |
| 1790954410 | Castlewood Treatment Center LLC | Community/Behavioral Health | 1855 Bowles Ave, Suite 210, Fenton, MO 63026 | 2008-02-27 |
| 1073703617 | Christina R Baeres | Dietitian, Registered | 38 Majestic Ct, Fenton, MO 63026 | 2007-07-30 |
| Find all providers in zip 63026 | ||||
| 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 |
|---|---|---|---|---|
| 1831452036 | Erin Holdren Otis | Podiatrist | 14229 Torrey Rd, Suite 1, Fenton, MI 48430-3308 | 2012-06-21 |
| 1831335819 | Ankle and Foot Institute of Missouri P.C. | Podiatrist | 1011 Bowles Avenue, Suite 123, Fenton, MO 63026 | 2008-12-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902421696 | Kiera Margaret Benge-shea | Podiatrist | 12255 Depaul Drive, Ste 705, Bridgeton, MO 63055 | 2020-06-09 |
| 1972069359 | Dr Jeffrey Brooks PC | Podiatrist | 618 N New Ballas Rd Apt 409, Saint Louis, MO 63141-6767 | 2019-02-11 |
| 1619448453 | S Thomas Sehy D P M L L C | Podiatrist | 6651 Chippewa St Ste 316, Saint Louis, MO 63109-2532 | 2018-12-05 |
| 1902339104 | Jay J Moradia | Podiatrist | 621 S New Ballas Rd Ste 7005b, Saint Louis, MO 63141-8275 | 2017-04-05 |
| 1992185763 | Melanie Gonzalez | Podiatrist | 2406 E R.d. Mize Rd Ste. B, Independence, MO 64057-6405 | 2015-06-05 |
| 1255727525 | Mobile Podiatry of Kansas, LLC | Podiatrist | 1920 Salter Pl, Kirksville, MO 63501-5165 | 2015-04-13 |
| 1346645496 | Ronald Ethan Freilich | Podiatrist | 25107 Cherokee Ln, Jonesburg, MO 63351-2454 | 2014-10-31 |
| 1972922060 | Special Care Podiatry of Missouri, LLC | Podiatrist | 3714 Kidron St, Jackson, MO 63755-3345 | 2014-04-16 |
| 1003152273 | Foot Healers Holdings - St. Louis, LLC | Podiatrist | 8534 Eager Rd, Saint Louis, MO 63144-1435 | 2012-12-17 |
| 1073870234 | Richard Don Bushman | Podiatrist | 603 Claymont Estates Dr, Chesterfield, MO 63017-7061 | 2012-04-12 |
| Find all providers with the same taxonomy | ||||
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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.