EASY WALK FOOT CLINIC LLC (NPI# 1508155037) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508155037 |
| Entity Type | Organization |
| Organization Name | EASY WALK FOOT CLINIC LLC |
| Practice Address |
101 Beckett Ln Suite 104 Fayetteville GA 30214-7155 |
| Mailing Address |
3364 Medina Dr Jonesboro GA 30236-6873 |
| Practice Telephone | 6784896589 |
| Practice Fax Number | 6784896522 |
| Mailing Telephone | 6464896589 |
| Mailing Fax Number | 6784896522 |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2012-07-16 |
| Authorized Official Name | DR. AZUKA IFEYINWA NWAEDOZIE (PODIATRIST/OWNER) |
| Authorized Official Telephone | 6784896589 |
| Authorized Official Credential | D.P.M |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
POD001142 | GA | Podiatric Medicine & Surgery Service Providers |
| Street Address |
101 BECKETT LN SUITE 104 |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-7155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083668271 | Salih O Faldon | Emergency Medicine | 101 Beckett Ln, 506, Fayetteville, GA 30214-7155 | 2006-05-20 |
| 1821461484 | Children 1st Pediatrics | Clinic/Center | 101 Beckett Ln, Suite 502, Fayetteville, GA 30214-7155 | 2015-11-04 |
| 1699146738 | Turning Point Counseling Services, LLC | Counselor | 101 Beckett Ln, Suite 505, Fayetteville, GA 30214-7155 | 2015-10-15 |
| 1033595566 | Omolola Otubaga | Nurse Practitioner | 101 Beckett Ln, Ste. 304, Fayetteville, GA 30214-7155 | 2015-08-06 |
| 1467858068 | Augusta Abbey | Secured Medical Transport (VAN) | 101 Beckett Ln, Suite 505, Fayetteville, GA 30214-7155 | 2014-11-08 |
| 1649549775 | Md 1 Care | Clinic/Center | 101 Beckett Ln, Suite 506, Fayetteville, GA 30214-7155 | 2011-12-19 |
| 1164702288 | God's In Control Transportation Services | Non-emergency Medical Transport (VAN) | 101 Beckett Ln, Suite 505, Fayetteville, GA 30214-7155 | 2011-08-20 |
| 1710284369 | Provider Resource Solutions of Georgia Inc | Foster Care Agency | 101 Beckett Ln, Suite 505, Fayetteville, GA 30214-7155 | 2011-02-17 |
| 1417251810 | Provider Resource Solutions of Georgia, Inc | Day Training, Developmentally Disabled Services | 101 Beckett Ln, Suite 505, Fayetteville, GA 30214-7155 | 2010-12-29 |
| 1205145414 | Provider Resource Solutions LLC | Supports Brokerage | 101 Beckett Ln, Fayetteville, GA 30214-7155 | 2010-10-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609288984 | Aaron Teufel | Podiatrist | 1794 E Joyce Blvd Ste 2, Fayetteville, AR 72703 | 2014-05-21 |
| 1073852786 | Ankle and Foot Clinic of Georgia, Inc. | Podiatrist | 730 Lanier Ave W, Fayetteville, GA 30214-1509 | 2013-02-01 |
| 1841597499 | American Foot & Leg Specialists, P.C. | Podiatrist | 122 N Park Dr, Fayetteville, GA 30214 | 2011-02-17 |
| 1821132424 | Fayetteville Foot and Ankle Center | Podiatrist | 503 Owen Dr, Fayetteville, NC 28304-3433 | 2007-02-16 |
| 1861496754 | Gregory Alvarez | Podiatrist | 265 N Jeff Davis Dr, Fayetteville, GA 30214-1625 | 2005-06-08 |
| 1619533692 | Arkansas Foot & Ankle Specialists | Podiatrist | 1794 E Joyce Blvd Ste 2, Fayetteville, AR 72703-5257 | 2019-05-15 |
| 1376906735 | Hughey Colton Carter | Podiatrist | 1738 Metromedical Dr, Fayetteville, NC 28304 | 2016-04-03 |
| 1710256003 | Ozark Foot & Ankle Plc | Podiatrist | 2828 E Millennium Pl, Suite 2, Fayetteville, AR 72703-6514 | 2011-12-15 |
| 1972827988 | Roberto Bermudez | Podiatrist | 1738 Metromedical Dr, Fayetteville, NC 28304-3861 | 2010-03-19 |
| 1437313194 | Denise Crystal Thomas | Podiatrist | 1738 Metromedical Dr, Fayetteville, NC 28304-3861 | 2008-07-11 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
Please comment or provide details below to improve the information on EASY WALK FOOT CLINIC LLC.
| 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.