JASON EBERLY (NPI# 1588657985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588657985 |
| Entity Type | Individual |
| Full Name | JASON EBERLY |
| Credential | DPM |
| Practice Address |
325 Blue Valley Dr Bangor PA 18013-1526 |
| Practice Telephone | 6105886621 |
| Practice Fax Number | 6105886307 |
| Mailing Telephone | 6105886621 |
| Mailing Fax Number | 6105886307 |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2015-04-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | SC004800L | PA | Podiatric Medicine & Surgery Service Providers |
| Street Address |
325 BLUE VALLEY DR |
| City | BANGOR |
| State | PA |
| Zip Code | 18013-1526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144590563 | Kathleen Anne Hope | Podiatrist | 325 Blue Valley Dr, Bangor, PA 18013-1526 | 2012-01-02 |
| 1053400804 | Cheralyn Suzanne Perkins | Podiatrist | 325 Blue Valley Dr, Bangor, PA 18013-1526 | 2006-10-12 |
| 1366491938 | Bangor Podiatry LLC | Podiatrist | 325 Blue Valley Dr, Bangor, PA 18013-1526 | 2006-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104298140 | Blue Valley Vision LLC | Eyewear Supplier (Equipment, not the service) | 455 Blue Valley Dr, Bangor, PA 18013 | 2015-10-29 |
| 1588064554 | Roxanne Decesare | Reflexologist | 429 South First St, Bangor, PA 18013 | 2014-08-27 |
| 1467781708 | Shadys Rest | Preferred Provider Organization | 1004 W Juniata Street, Allentown, PA 18013 | 2009-12-16 |
| 1912911371 | Richard J Weaver | Chiropractor | 83 Bangor Junction Road, Blue Valley Plaza, Bangor, PA 18013 | 2006-07-28 |
| 1104373265 | Heavenly Vision | Technician/Technologist | 455 Blue Valley Dr, Bangor, PA 18013 | 2016-09-07 |
| 1881059293 | Timothy James Velekei Sr. | Technician/Technologist | 455 Blue Valley Dr, Bangor, PA 18013 | 2015-12-30 |
| 1629492608 | Elizabeth Kostura | Counselor | 51 Market Street, Bangor, PA 18013 | 2014-02-11 |
| 1518261593 | Carol Augusta Olzinski | Social Worker | 51 Market Street, Bangor, PA 18013 | 2011-01-05 |
| 1073846390 | Christa Robinson | Specialist/Technologist | 19 Columbus St, Apt 3, Roseto, PA 18013 | 2009-09-18 |
| 1326096587 | Matthew Nicholas Sabatine Jr. | Dentist | 137 Broadway, Bangor, PA 18013 | 2006-05-04 |
| Find all providers in zip 18013 | ||||
| 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 |
|---|---|---|---|---|
| 1154425403 | Joseph M Constantine | Podiatrist | 300 Hammond St, Bangor, ME 04401 | 2006-09-08 |
| 1962483719 | F Douglas Reynolds | Podiatrist | 700 Mount Hope Ave Ste 620, Bangor, ME 04401-5671 | 2005-11-09 |
| 1477556652 | Edwin Jay Bruno | Podiatrist | 277 State St, Ste 1b, Bangor, ME 04401-5440 | 2005-05-23 |
| 1740415520 | William K Dahl | Podiatrist | 205 French St, Bangor, ME 04401-5064 | 2009-05-21 |
| 1538248141 | Sunbury Primary Care, P.a. | Podiatrist | 900 Broadway, Building 1, Bangor, ME 04401-1900 | 2006-11-03 |
| 1326121294 | Acadia Foot & Ankle Pa | Podiatrist | 700 Mount Hope Ave Ste 620, Bangor, ME 04401-3667 | 2006-10-23 |
| 1164490009 | Keith S Kendall | Podiatrist | 700 Mount Hope Ave Ste 620, Bangor, ME 04401-5671 | 2006-03-08 |
| 1134100456 | Adam W Darcy | Podiatrist | 700 Mount Hope Ave Ste 620, Bangor, ME 04401-5671 | 2005-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528674462 | Difranco Family Foot Care LLC | Podiatrist | 4044 Sandalwood Dr, Erie, PA 16506-4764 | 2020-09-16 |
| 1952916736 | Patrick J Rush | Podiatrist | 24 Woodstock Drive, Newtown, PA 18940 | 2020-09-09 |
| 1558980904 | Ralph Mazer | Podiatrist | 31 W Ashland St, Doylestown, PA 18901-4228 | 2020-04-15 |
| 1861032039 | Annalisa Donnelly | Podiatrist | 1000 Floral Vale Blvd #400, Morrisville, PA 19067 | 2020-01-15 |
| 1831736024 | Christopher A Panek Dpm PC | Podiatrist | 9000 Perry Hwy Ste 210, Pittsburgh, PA 15237-5367 | 2019-12-06 |
| 1912543109 | Kimberly Nguyen Dpm PC | Podiatrist | 1930 S Broad St Ste 19, Philadelphia, PA 19145-2328 | 2019-11-21 |
| 1821655861 | Dean M Ruday Dpm | Podiatrist | 2404 Bristol Road, Bensalem, PA 19020-6002 | 2019-05-24 |
| 1326601816 | John Scheland, Dpm PC | Podiatrist | 3 Abington Executive Park Ste 7, Clarks Summit, PA 18411-2269 | 2019-04-19 |
| 1790250033 | Gentle Touch Mobile Podiatry, LLC | Podiatrist | 128 Whistle Dr, Harrison City, PA 15636-1252 | 2018-10-12 |
| 1154802825 | Lisa Rhodes | Podiatrist | 5055 Swamp Rd Ste 203, Fountainville, PA 18923-9656 | 2018-08-22 |
| 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.