A FOOT DOCTOR, PLLC (NPI# 1255505004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255505004 |
| Entity Type | Organization |
| Organization Name | A FOOT DOCTOR, PLLC |
| Practice Address |
2631 12th Ave S Fargo ND 58103-8741 |
| Practice Telephone | 7012320900 |
| Mailing Telephone | 7012320900 |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2010-08-02 |
| Authorized Official Name | DR. BRUCE MORGAN (PRESIDENT) |
| Authorized Official Telephone | 7012320900 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 52 | ND | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 13725 | 05 | |
| MN | MEDICA | 2700617 | 01 |
| ND | BLUE SHIELD GROUP | 06796001 | 01 |
| MN | HEALTHPARTNERS HPFIN | 126502 | 01 |
| MN | BLUE SHIELD MN GROUP | 03N87MO | 01 |
| RAILROAD MEDICARE | P00320486 | 01 |
| Street Address |
2631 12TH AVE S |
| City | FARGO |
| State | ND |
| Zip Code | 58103-8741 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306923644 | B.k. Spine Care, Inc. | Physical Therapist | 2631 12th Ave S, Fargo, ND 58103-8741 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659924843 | Amanda Hericks | Dentist | 1338 Gateway Drive S, Fargo, ND 58103 | 2019-07-17 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1245706597 | Lisa Elaine Livingston | Counselor | 1337 14 and Half St. S., Fargo, ND 58103 | 2018-10-15 |
| 1528569662 | Misty Lynn Hagen | Counselor | 901 28th St. South, Suite B, Fargo, ND 58103 | 2018-02-23 |
| 1083133011 | Faith Homecare Professionals LLC | Home Health | 304 25th St S, Suite B, Fargo, ND 58103 | 2017-09-11 |
| 1982138749 | Matthew Troyer | Pharmacist | 2425 13th Ave, Fargo, ND 58103 | 2017-04-18 |
| 1801338504 | Amy Nguyen Christianson | Chiropractor | 1650 45th St S Ste 113, Fargo, ND 58103 | 2016-11-11 |
| 1245772359 | Andrea Marie Hanson | Nurse Practitioner | 2400 32nd Ave South, Fargo, ND 58103 | 2016-11-07 |
| 1831647940 | Abigail Carmen Burkett Vetter | Nurse Practitioner | 2928 University Dr S Suite 101, Fargo, ND 58103 | 2016-09-18 |
| 1013361302 | Nancy Knowlton | Speech-Language Pathologist | 3001 11th Ave S, Beyond Boundaries Speech-language, Fargo, ND 58103 | 2016-04-22 |
| Find all providers in zip 58103 | ||||
| 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 |
|---|---|---|---|---|
| 1114453552 | Derek Anthony Mclister | Podiatrist | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2017-05-04 |
| 1265845010 | Mark Domaas | Podiatrist | 4450 31st Ave S, Ste 102, Fargo, ND 58104-4557 | 2014-06-10 |
| 1649298381 | Brad C Anderson | Podiatrist | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2006-07-18 |
| 1902824600 | Richard E Arness | Podiatrist | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2006-07-18 |
| 1972534642 | Lee A Hofsommer | Podiatrist | 1702 University Dr S, Fargo, ND 58103-4940 | 2006-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902933401 | Richard Gary Mason | Podiatrist | 3883 74th St. N.e., 3883 74th St. N.e., Fort Totten, ND 58335-0309 | 2007-02-28 |
| 1942341086 | Nathan Richard Randall | Podiatrist | 1 Main Hospital Road, Box 160, Belcourt, ND 58316-0160 | 2007-02-10 |
| 1386654424 | Jessica Anne Bentson | Podiatrist | 525 N 9th St, Bismarck, ND 58501-4510 | 2006-08-09 |
| 1336173871 | Basem Fanous | Podiatrist | Hwy 281n, Cando, ND 58324-0688 | 2006-07-10 |
| 1518965276 | Cherian Mathew | Podiatrist | 2215 Sims St, Dickinson, ND 58601-6521 | 2005-07-07 |
| 1992206528 | Elbowoods Memorial Health Center | Podiatrist | 1058 College Dr, New Town, ND 58763-9112 | 2018-02-28 |
| 1184010969 | Adam Finzen | Podiatrist | 4440 S Washington St - Altru Professional Center, Grand Froks, ND 58201-7245 | 2015-04-08 |
| 1659788164 | Kayla Marie Emter | Podiatrist | 2422 20th St Sw, Jamestown, ND 58401-6201 | 2014-07-16 |
| 1407111321 | Andrew Dean Knudsen | Podiatrist | 401 N 9th St, Bismarck, ND 58501-4530 | 2012-07-06 |
| 1326306630 | Burkley Jensen | Podiatrist | 300 N 7th St, Bismarck, ND 58501 | 2012-04-25 |
| 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.