HEALTHDRIVE PODIATRY GROUP, PA (NPI# 1518112499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518112499 |
| Entity Type | Organization |
| Organization Name | HEALTHDRIVE PODIATRY GROUP, PA |
| Other Organization Name | MARY C. MANESIS, DPM, PA |
| Practice Address |
2413 East Loop 820 North Fort Worth TX 76118-8210 |
| Mailing Address |
100 Crossing Blvd Suite 300 Framingham MA 01702-5555 |
| Practice Telephone | 8889646681 |
| Practice Fax Number | 8886620859 |
| Mailing Telephone | 6179646681 |
| Mailing Fax Number | 3396862561 |
| Enumeration Date | 2008-11-19 |
| Last Update Date | 2020-01-02 |
| Authorized Official Name | MICHELE L. TRBOVICH (OWNER/PRACTICE DIRECTOR) |
| Authorized Official Telephone | 8572550486 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | MEDICARE RAILROAD | DD6485 | 01 |
| TX | 201090202 | 05 |
| Other Name | Type Code |
|---|---|
| HealthDrive Podiatry Group | Doing Business As Name - Organization |
| Mary C. Manesis, DPM, PA | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972764645 | Healthdrive Podiatry Group, Pa | Podiatrist | 100 Crossing Blvd, Suite 300, Framingham, MA 01702-5555 | 2008-06-24 |
| 1104861475 | Healthdrive Podiatry Group, Pa | Podiatrist | 4201 Fm 1960 Rd W, Suite # 230, Houston, TX 77068-3414 | 2006-06-19 |
| Street Address |
2413 EAST LOOP 820 NORTH |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76118-8210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447707070 | Hdc Podiatry, LLC | Podiatrist | 2413 East Loop 820 North, Fort Worth, TX 76118-8210 | 2016-09-01 |
| 1366697245 | Alec H. Jaret, Dmd, Pa | Dentist | 2413 East Loop 820 North, Fort Worth, TX 76118-8208 | 2008-11-19 |
| 1437304318 | Jeffrey L. Morer, Od, Pa | Optometrist | 2413 East Loop 820 North, Fort Worth, TX 76118-8210 | 2008-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619475936 | Ellen Dixon | Specialist/Technologist | 9502 Garden Wood Drive Apt 421, Fort Worth, TX 76118 | 2018-02-01 |
| 1588016067 | Bartholomew Henderson | Registered Nurse | 3604 Scranton Dr, Richland Hills, TX 76118 | 2016-07-07 |
| 1447548391 | Brent Cooper Orr | Technician, Other | 7415 Whitehall Street Suite 118, Ft Worth, TX 76118 | 2011-07-13 |
| 1972804300 | National Hme | Durable Medical Equipment & Medical Supplies | 7451 Airport Freeway, Richland Hills, TX 76118 | 2010-11-17 |
| 1053572628 | C3 Christian Academy LLC | Respite Care | 6609 Baker Blvd, Richland Hills, TX 76118 | 2008-06-17 |
| 1922282946 | C3 Academy, LLC | Custodial Care Facility | 6609 Baker Blvd., Richland Hills, TX 76118 | 2007-12-27 |
| 1770787202 | George L Ruffin | Counselor | 6900 Boulevard 26, Richland Hills, TX 76118 | 2007-06-11 |
| 1649322629 | Bestcare Home Health,inc | Home Health | 7215-a Baker Blvd., Richland Hills, TX 76118 | 2007-01-18 |
| 1972692838 | Clearview Medical Incorporated | Durable Medical Equipment & Medical Supplies | 2503 Gravel Dr, Fort Worth, TX 76118 | 2006-10-11 |
| 1790753689 | Breath of Life, Inc. | Durable Medical Equipment & Medical Supplies | 2612 Gravel Dr, Bldg 7, Fort Worth, TX 76118 | 2006-03-08 |
| Find all providers in zip 76118 | ||||
| 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 |
|---|---|---|---|---|
| 1598031841 | Candace Frances Been | Podiatrist | Federal Bureau of Prisons Federal Medical Center Fort, 3150 Horton Road, Fort Worth, TX 76119 | 2012-03-30 |
| 1124263512 | Kevin D. Rhodes, Dpm | Podiatrist | 750 North Fwy, Fort Worth, TX 76102-1722 | 2008-12-13 |
| 1205980232 | South Side Foot Clinic Inc. | Podiatrist | 4759 South Fwy, Suite B, Fort Worth, TX 76115-3655 | 2007-01-23 |
| 1629135157 | Kyle E Hoogendoorn | Podiatrist | 6048 Lake Worth Blvd, Fort Worth, TX 76135-3706 | 2007-01-03 |
| 1558440750 | Raiford Adrian Rattan | Podiatrist | 2716 Cockrell Ave, Fort Worth, TX 76109-1119 | 2006-11-06 |
| 1538253083 | Sherry Lynn Bowers | Podiatrist | 1305 W Magnolia Ave, Suite B, Fort Worth, TX 76104-4351 | 2006-10-02 |
| 1679670970 | William Douglas Boyd | Podiatrist | 3221 Hulen, Suite A, Fort Worth, TX 76107 | 2006-09-20 |
| 1053426601 | Kenneth Lynn James | Podiatrist | 1712 Pennsylvania Ave, Fort Worth, TX 76104 | 2006-08-21 |
| 1720098221 | Thu Cao Nguyen | Podiatrist | 1617 N Beach St, Fort Worth, TX 76111-6617 | 2006-08-08 |
| 1588608459 | Alan G Garrett | Podiatrist | 800 5th Ave Ste 400, Fort Worth, TX 76104 | 2006-06-15 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76118 |
Please comment or provide details below to improve the information on HEALTHDRIVE PODIATRY GROUP, PA.
| 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.