WILLIAMSBURG FOOT & ANKLE SPECIALISTS P.C. (NPI# 1457482622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457482622 |
| Entity Type | Organization |
| Organization Name | WILLIAMSBURG FOOT & ANKLE SPECIALISTS P.C. |
| Practice Address |
453 Mclaws Cir Suite 1 Williamsburg VA 23185-5645 |
| Mailing Address |
Po Box 5635 Williamsburg VA 23188-5210 |
| Practice Telephone | 7572203311 |
| Practice Fax Number | 7572209070 |
| Mailing Telephone | 7572203311 |
| Mailing Fax Number | 7572209070 |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2010-12-08 |
| Authorized Official Name | DR. MARK ALLYN GARDNER (PRESIDENT) |
| Authorized Official Telephone | 7572203311 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
0103000917 | VA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | ANTHEM | 115887 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Williamsburg Foot & Ankle Specialists P.C. | 212 Grassy Ridge Terrace, Purcellville, Virginia 20132 |
| Street Address |
453 MCLAWS CIR SUITE 1 |
| City | WILLIAMSBURG |
| State | VA |
| Zip Code | 23185-5645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336131473 | Mark A Gardner | Podiatrist | 453 Mclaws Cir, Suite 1, Williamsburg, VA 23185-5645 | 2005-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215579412 | Marian Shearin | Technician | 112 Indian Circle, Williamsburg, VA 23185 | 2019-10-09 |
| 1093363251 | 1st Choice In-homecare, Inc. | Durable Medical Equipment & Medical Supplies | 161-a John Jefferson Road Ste 101, Williamsburg, VA 23185 | 2019-08-30 |
| 1265939482 | Michelle Antionette Hill | Counselor | 1769 Jamestown Rd Ste 107, Williamsburg, VA 23185 | 2018-04-13 |
| 1114437480 | Kimberly Anne Allan | Orthotic Fitter | 1811 Jamestown Rd., Williamsburg, VA 23185 | 2017-10-02 |
| 1881115590 | Shawn Patrick Mcnulty | Counselor | Colonial Behavioral Health, 1657 Merrimac Trail, Williamsburg, VA 23185 | 2017-07-03 |
| 1790215986 | Sea Change Therapy Pllc | Community/Behavioral Health | 3308 Ash Vw, Williamsburg, VA 23185 | 2017-06-19 |
| 1316479322 | Maureen Bounds | Pharmacist | 230 Gooch Dr, Williamsburg, VA 23185 | 2017-03-29 |
| 1386196970 | Joshua Desilva | Psychologist | 240 Gooch Drive, 2nd Floor, Williamsburg, VA 23185 | 2016-10-29 |
| 1750837001 | Ellen Lerose | Pharmacist | 5601-b Richmond Road, Williamsburg, VA 23185 | 2016-08-28 |
| 1194173922 | Michael C. Shuck, Dds PC | Dentist | 1480 Quarterpath Rd, Ste 2a, Williamsburg, VA 23185 | 2016-06-02 |
| Find all providers in zip 23185 | ||||
| Taxonomy Code | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| 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 |
| 1356497622 | Benedict A Profera | Podiatrist | 1589 Innsbrooke Dr, Salem, VA 24153-1785 | 2007-01-26 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | WILLIAMSBURG |
| Zip Code | 23185 |
Please comment or provide details below to improve the information on WILLIAMSBURG FOOT & ANKLE SPECIALISTS P.C..
| 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.