DR. MOHSEN KHOSHNEVISZADEH (NPI# 1376564971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376564971 |
| Entity Type | Individual |
| Full Name | DR. MOHSEN KHOSHNEVISZADEH |
| Credential | DPM |
| Practice Address |
2400 Mount Zion Pkwy Southwood Medical Center - Dept of Podiatry Jonesboro GA 30236-2500 |
| Mailing Address |
2710 Margaret Mitchell Dr Nw Atlanta GA 30327-1841 |
| Practice Telephone | 7706033547 |
| Mailing Telephone | 4045499345 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | POD001005 | GA | Podiatric Medicine & Surgery Service Providers |
| Street Address |
2400 MOUNT ZION PKWY SOUTHWOOD MEDICAL CENTER - DEPT OF PODIATRY |
| City | JONESBORO |
| State | GA |
| Zip Code | 30236-2500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871568303 | David W Lazan | Urology | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2006-02-20 |
| 1033721113 | Hannah Yael Paull | Psychologist | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2020-08-19 |
| 1497316343 | Alexandra Blackburn | Nurse Practitioner | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2019-06-21 |
| 1811459944 | Lisa Fraser-powell | Social Worker | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2019-04-06 |
| 1093244220 | Megan Deanne Griffin | Physician Assistant | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2017-06-10 |
| 1104358803 | Simone Keinia Sharp-bucknor | Registered Nurse | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2017-03-31 |
| 1740712454 | Lisa Pruitt | Registered Nurse | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2017-03-31 |
| 1063952752 | Kayla Randle | Pharmacist | 2400 Mount Zion Pkwy, Suite 116, Jonesboro, GA 30236-2500 | 2017-03-01 |
| 1952849531 | Anna Broadus | Nurse Practitioner | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2017-02-03 |
| 1649656653 | Hector George Clarke Jr. | Pharmacist | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2015-08-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972123362 | Life Source Counseling & Consulting, LLC | Clinic/Center | 118 North Avenue, Suite A, Jonesboro, GA 30236 | 2020-04-25 |
| 1639609555 | New Beginnings Behavioral Counseling,llc | Social Worker | 9456 S Main St Ste E2, Jonesboro, GA 30236 | 2017-06-13 |
| 1437696762 | Clarissa Alexandra Poole | Counselor | 2106 Fair Ridge Ct, Jonesboro, GA 30236 | 2017-01-25 |
| 1588012892 | Sundance Healthcare Service Inc | In Home Supportive Care | 7861 Collinswood Court, Jonesboro, GA 30236 | 2016-05-26 |
| 1942669205 | Adrianne Smiley Gurley | Occupational Therapist | 1299 Battlecreek Rd Ste 210, Jonesboro, GA 30236 | 2016-02-15 |
| 1336505809 | Integrated Health Center | Dentist | 8600 Tara Blvd, Suite D, Jonesboro, GA 30236 | 2016-01-13 |
| 1467827402 | Surrell Porter | Nurse Practitioner | 1287 Georgia Highway 138 Spur, Suite 8, Jonesboro, GA 30236 | 2015-12-02 |
| 1740688910 | Jacqueline Carolyn Edwards | Registered Nurse | 8081 Tara Blvd, 265, Jonesboro, GA 30236 | 2014-12-19 |
| 1770991861 | Lower Extremity Diagnostics, LLC | Podiatrist | 6911 Tara Boulevard, Jonesboro, GA 30236 | 2014-08-01 |
| 1760899710 | Fresenius Medical Care Jonesboro, LLC | Clinic/Center | 8060 Summitt Business Parkway, Jonesboro, GA 30236 | 2014-07-22 |
| Find all providers in zip 30236 | ||||
| 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 |
|---|---|---|---|---|
| 1861436875 | Michael Allen Haughey | Podiatrist | 1416 E Matthews Ave Ste 200, Jonesboro, AR 72401 | 2006-06-16 |
| 1235131640 | Eddy Lloyd Caldwell | Podiatrist | 406 E Washington Ave, Jonesboro, AR 72401-3108 | 2005-08-15 |
| 1346246352 | Walter Wadsworth Hayes | Podiatrist | 1000 Windover, Suite A, Jonesboro, AR 72401 | 2005-06-23 |
| 1215931951 | Lee Paul Woodruff | Podiatrist | 1815 Executive Sq, Jonesboro, AR 72401-6086 | 2005-06-10 |
| 1114264652 | Jaclyn Marie Schwartz | Podiatrist | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236 | 2013-01-03 |
| 1255698627 | Vinay Kumar Matai | Podiatrist | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2012-04-23 |
| 1750550489 | Foot Care of Northeast Arkansas Pa | Podiatrist | 406 E Washington Ave, Jonesboro, AR 72401-3108 | 2008-02-27 |
| 1184756280 | Christopher Rowlett | Podiatrist | 4802 E Johnson Ave, Jonesboro, AR 72401 | 2007-03-12 |
| 1013940394 | Walter W. Hayes, D.p.m., P.a. | Podiatrist | 1000 Windover, Suite A, Jonesboro, AR 72401 | 2006-07-09 |
| 1396742870 | Clayton Mobile Diagnostic Clinic | Podiatrist | 6911 Tara Blvd, Jonesboro, GA 30236-1503 | 2005-06-30 |
| Find all providers in JONESBORO | ||||
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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.