DIABETIC FOOT CENTER OF TIDEWATER (NPI# 1306904800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306904800 |
| Entity Type | Organization |
| Organization Name | DIABETIC FOOT CENTER OF TIDEWATER |
| Other Organization Name | JANAF FOOT AND ANKLE CENTER |
| Practice Address |
5900 E. Virginia Beach Blvd Suite 101 Norfolk VA 23502 |
| Practice Telephone | 7574614500 |
| Practice Fax Number | 7574660928 |
| Mailing Telephone | 7574614500 |
| Mailing Fax Number | 7574660928 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. WILLIAM P. GRANT (OWNER) |
| Authorized Official Telephone | 7574614500 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers |
| Other Name | Type Code |
|---|---|
| Janaf Foot and Ankle Center | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Diabetic Foot Center of Tidewater Inc. | P O Box 55335, Virginia Beach, Virginia 23471 |
| Street Address |
5900 E. VIRGINIA BEACH BLVD SUITE 101 |
| City | NORFOLK |
| State | VA |
| Zip Code | 23502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295210706 | Advantage Home Care, LLC | Home Health | 5353 E. Princess Anne Rd., Suite C, Norfolk, VA 23502 | 2018-10-01 |
| 1336627207 | Sentara Medical Group | Emergency Medicine | 844 Kempsville Rd Ste 103, Norfolk, VA 23502 | 2018-08-02 |
| 1548753833 | Murphy's Absolute Home Care LLC | Home Health | 983 Ingleside Rd Ste 6, Norfolk, VA 23502 | 2018-06-11 |
| 1487143939 | Valerie Sowder | Social Worker | 6275 E Virginia Beach Blvd Ste 301, Norfolk, VA 23502 | 2018-05-09 |
| 1164938841 | Accupoint Diagnostics | Clinical Medical Laboratory | 6161 Kempsville Cir Ste 202, Norfolk, VA 23502 | 2017-12-18 |
| 1467979351 | Lakeshia Louise Perryman | Counselor | 6325 N. Center Drive, Bldg 18, Suite 208, Norfolk, VA 23502 | 2017-08-23 |
| 1841536125 | Golden Touch Enterprise | Durable Medical Equipment & Medical Supplies | 5680 Lowey Rd, Unit 410b, Norfolk, VA 23502 | 2012-12-14 |
| 1497029011 | Kristine B Rand | Counselor | 6325 N Center Dr Ste 208, Norfolk, VA 23502 | 2012-02-29 |
| 1427343706 | Erica Leigh Streander | Pharmacist | 471 North Military Hwy, Norfolk, VA 23502 | 2011-06-14 |
| 1215239330 | Atlantic Physical Therapy | Specialist/Technologist | 5610 Lewis Rd, Norfolk, VA 23502 | 2010-11-22 |
| Find all providers in zip 23502 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881887263 | Blayne H Mccaffrey | Podiatrist | 1105 S 13th St Ste 201, Norfolk, NE 68701-5767 | 2007-08-20 |
| 1578948808 | Active Foot and Ankle of Norfolk Plc | Podiatrist | 6204 N Military Hwy, Norfolk, VA 23518-5447 | 2015-07-28 |
| 1215284468 | Foot and Ankle Doctors PC | Podiatrist | 110 N 37th St, 101, Norfolk, NE 68701-3283 | 2012-08-07 |
| 1962768325 | Zackary Bryan Gangwer | Podiatrist | 301 N 27th St, Ste 5, Norfolk, NE 68701-4401 | 2012-04-10 |
| 1629366232 | Jason Raymond Bailey | Podiatrist | 301 N 27th St, Suite 5, Norfolk, NE 68701-4401 | 2011-07-17 |
| 1356542922 | Tidewater Podiatry Group Ltd | Podiatrist | 6161 Kempsville Cir, Ste 230, Norfolk, VA 23502-3932 | 2007-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952909228 | The Ankle and Foot Clinic of Northern Virginia, Pllc | Podiatrist | 12628 Tide View Ct, Bristow, VA 20136-1175 | 2020-10-09 |
| 1912542713 | Michael A Dente Jr Dpm Plc | Podiatrist | 356 Mclaws Cir Ste 1, Williamsburg, VA 23185-6345 | 2019-11-15 |
| 1609431964 | Ana Anahit Emirzian | Podiatrist | 3300 Gallows Road, Original Building, Falls Church, VA 22042-3307 | 2019-05-02 |
| 1508329913 | District Foot and Ankle | Podiatrist | 4875 Eisenhower Ave Ste 230, Alexandria, VA 22304-4833 | 2019-04-11 |
| 1104300359 | Vineela Ayyagari | Podiatrist | 9017 Fletcher Farm Ct, Manassas, VA 20112-5867 | 2018-09-23 |
| 1083137871 | Rural Podiatry, LLC | Podiatrist | 7010 Mountain Rd, Halifax, VA 24558-2392 | 2017-07-24 |
| 1356863781 | Chen Foot & Ankle Center LLC | Podiatrist | 1948 Jenkins Mill Rd, Suffolk, VA 23437-9401 | 2017-07-07 |
| 1568982247 | Soumaya Bader | Podiatrist | 632 Cedar Rd Ste B, Chesapeake, VA 23322-8376 | 2017-06-22 |
| 1013440569 | Richard Bruno | Podiatrist | 2790 Godwin Blvd Ste 355, Suffolk, VA 23434-8173 | 2017-04-11 |
| 1497289961 | David Chan | Podiatrist | 224d Cornwall St Nw # 203100, Leesburg, VA 20176-2713 | 2017-04-11 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DIABETIC FOOT CENTER OF TIDEWATER.
| 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.