DR. BENEDICT A PROFERA (NPI# 1356497622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356497622 |
| Entity Type | Individual |
| Full Name | DR. BENEDICT A PROFERA |
| Credential | DPM, MPH |
| Practice Address |
1589 Innsbrooke Dr Salem VA 24153-1785 |
| Practice Telephone | 5403896267 |
| Mailing Telephone | 5403896267 |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
0103000566 | VA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 010265851 | 05 |
| Street Address |
1589 INNSBROOKE DR |
| City | SALEM |
| State | VA |
| Zip Code | 24153-1785 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669001228 | Paul Mcguire | Student in an Organized Health Care Education/Training Program | 1906 Braeburn Drive Psychiatry Gme, Salem, VA 24153 | 2020-04-06 |
| 1386114965 | Dynamic Medical LLC | Clinical Medical Laboratory | 1201 Texas Street, Salem, VA 24153 | 2018-11-27 |
| 1134607898 | Renew Psychiatry Services | Psychiatry & Neurology | 177 Electric Rd, Salem, VA 24153 | 2018-08-03 |
| 1508304015 | Samantha Getz | Assisted Living Facility | 3706 Knollridge Rd., Salem, VA 24153 | 2017-02-03 |
| 1518409762 | Melissa Ward | Case Manager/Care Coordinator | 1380 Southside Dr, Suite 100, Salem, VA 24153 | 2016-11-04 |
| 1154729051 | Allison Marie Parry | Physician Assistant | 1336 W Main St., Salem, VA 24153 | 2014-12-09 |
| 1598199457 | Stacy Stanley | Occupational Therapy Assistant | 4812 Moore Rd, Salem, VA 24153 | 2013-08-28 |
| 1366888034 | Dolores Hager | Speech-Language Pathologist | 1851 Harrogate Dr, Salem, VA 24153 | 2013-05-21 |
| 1073850764 | Joel Aaron Nickerson | Specialist/Technologist | 400 Spartan Dr., Salem High School, Salem, VA 24153 | 2013-01-15 |
| 1023387271 | National Diabetic Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 2153 Apperson Drive, Salem, VA 24153 | 2011-12-16 |
| Find all providers in zip 24153 | ||||
| Taxonomy Code | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740379387 | James E Lisle | Podiatrist | 3474 Liberty Rd S, Salem, OR 97302-4607 | 2006-10-12 |
| 1124661517 | Trevor Tippets Dpm LLC | Podiatrist | 3474 Liberty Rd S, Salem, OR 97302-4607 | 2019-10-18 |
| 1619394061 | Jarod Spencer | Podiatrist | 5125 Skyline Rd S, Salem, OR 97306-9427 | 2014-03-24 |
| 1528368883 | James E. Lisle Dpm LLC | Podiatrist | 3474 Liberty Rd S, Salem, OR 97302-4607 | 2010-11-02 |
| 1457660904 | Dpmbeckmannnror LLC | Podiatrist | 3760 Market St Ne # 105, Salem, OR 97301-1826 | 2010-10-01 |
| 1073785648 | James E. Lisle | Podiatrist | 3474 Liberty Rd S, Salem, OR 97302-4607 | 2008-03-24 |
| 1346435864 | Toni D Chadwick | Podiatrist | 1970 Roanoke Blvd, Salem, VA 24153-6404 | 2007-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528598281 | James H Chung | Podiatrist | 2826 Old Lee Hwy Ste 220, Fairfax, VA 22031-4348 | 2017-06-15 |
| 1750730628 | Podiatry Home Care LLC | Podiatrist | 1567 Aspin Ave, Suite B, Norfolk, VA 23502-1532 | 2016-06-10 |
| 1922405174 | Hampton Roads Foot & Ankle Clinic | Podiatrist | 17 Moore Rd, Poquoson, VA 23662-1105 | 2014-12-02 |
| 1295171858 | Thomas John Davidson Iv | Podiatrist | 1331 Hamilton Ter Se, Roanoke, VA 24014-1805 | 2013-05-21 |
| 1881955243 | Foothold Podiatry | Podiatrist | 1417 Claiborne St, Richmond, VA 23220-6431 | 2012-06-01 |
| 1922170919 | Foot Care of Hampton Roadspc | Podiatrist | 4317 Ainslie Ct S, Suffolk, VA 23434-7007 | 2006-11-14 |
| 1104997600 | David Elwood Detwiler | Podiatrist | 1232 Ty Bluff Road, Forest, VA 24551-1851 | 2006-11-13 |
| 1689776114 | Rodney A Kander | Podiatrist | 14200 Milltown Rd, Lovettsville, VA 20180-3314 | 2006-09-04 |
| 1255343083 | John G Piacenti | Podiatrist | 1416 Shenandoah Pkwy, Chesapeake, VA 23320-8137 | 2006-08-12 |
| 1447260823 | Audrey Delores Arthur | Podiatrist | 308 Horace Ave, Virginia Beach, VA 23462-2704 | 2006-08-09 |
| 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.