DR. JASON G DE VRIES (NPI# 1609028422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609028422 |
| Entity Type | Individual |
| Full Name | DR. JASON G DE VRIES |
| Credential | DPM |
| Practice Address |
501 N 10th St Manitowoc WI 54220-4039 |
| Mailing Address |
164 N Broadway Green Bay WI 54303-2728 |
| Practice Telephone | 9206826376 |
| Practice Fax Number | 9206520115 |
| Enumeration Date | 2008-10-13 |
| Last Update Date | 2016-04-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 940 | WI | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
940-25 | WI | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
940-025 | WI | Podiatric Medicine & Surgery Service Providers |
| Street Address |
501 N 10TH ST |
| City | MANITOWOC |
| State | WI |
| Zip Code | 54220-4039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699744730 | Jonathon Charles Henry | Orthopaedic Surgery | 501 N 10th St, Manitowoc, WI 54220-4039 | 2006-03-14 |
| 1962036830 | Kellie Greenwood | Registered Nurse | 501 N 10th St, Manitowoc, WI 54220-4039 | 2020-02-28 |
| 1275173072 | Saralyn Schleis | Specialist/Technologist, Other | 501 N 10th St, Manitowoc, WI 54220-4039 | 2020-01-09 |
| 1801310818 | Margaret Jane Konopasek | Physician Assistant | 501 N 10th St, Manitowoc, WI 54220-4039 | 2017-08-01 |
| 1023541547 | Andrea Cook | Occupational Therapist | 501 N 10th St, Manitowoc, WI 54220-4039 | 2017-04-11 |
| 1538538319 | Nichole Olson | Specialist/Technologist, Other | 501 N 10th St, Manitowoc, WI 54220-4039 | 2015-09-22 |
| 1356745640 | Evan Richard Mulder | Specialist/Technologist | 501 N 10th St, Manitowoc, WI 54220 | 2014-10-15 |
| 1164836201 | Stacey L Hladish | Physician Assistant | 501 N 10th St, Manitowoc, WI 54220 | 2014-06-17 |
| 1639441785 | Stephanie L Mccabe | Physical Therapist | 501 N 10th St, Manitowoc, WI 54220-4039 | 2012-02-06 |
| 1902082456 | Kimberly Sullivan | Specialist/Technologist | 501 N 10th St, Manitowoc, WI 54220-4039 | 2008-01-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235614843 | Katherine Borchardt | Registered Nurse | 3520 Foxfire Ct, Manitowoc, WI 54220 | 2018-09-28 |
| 1285128215 | Aurora Pharmacy Inc | Pharmacy | 3509 Dewey Street, Suite 100, Manitowoc, WI 54220 | 2018-06-22 |
| 1477937274 | Baycare Clinic LLP | Psychiatry & Neurology | 4801 Expo Drive, Manitowoc, WI 54220 | 2015-07-13 |
| 1831593821 | Brittany Camille Schultz | Acupuncturist | 2510 Washington Street, Manitowoc, WI 54220 | 2014-10-20 |
| 1710311261 | Brian E Weitz | Physical Therapy Assistant | 960 S. Rapids Rd., Manitowoc, WI 54220 | 2013-09-01 |
| 1134499080 | Total Renal Care Inc | Clinic/Center | 3303 Dewey St, Manitowoc, WI 54220 | 2012-01-10 |
| 1679858534 | Lisa M Noworatzky | Marriage & Family Therapist | 926 S. 8th St., Manitowoc, WI 54220 | 2011-10-11 |
| 1306177225 | Cynthia Fay Wenzel | Licensed Practical Nurse | 915 East Linden Avenue, Manitowoc, WI 54220 | 2010-01-15 |
| 1851550628 | Roundys Supermarkets Inc | Pharmacy | 3300 Calumet Ave, Manitowoc, WI 54220 | 2008-06-05 |
| 1851566079 | Jennifer C Mcwilliams | Registered Nurse | 1004 Nth 8th St., Manitowoc, WI 54220 | 2008-04-29 |
| Find all providers in zip 54220 | ||||
| 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 |
|---|---|---|---|---|
| 1710090345 | Gary Joseph Francar | Podiatrist | 702 Hamilton St, Manitowoc, WI 54220 | 2006-08-17 |
| 1548260060 | Jonathan A Snellgrove | Podiatrist | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2005-07-27 |
| 1568559490 | Holy Family Memorial Inc | Podiatrist | 1650 S 41st St, Manitowoc, WI 54220-7316 | 2006-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161976 | Family Foot and Ankle Clinic LLC | Podiatrist | 1901 Westwood Boulevard, Wausau, WI 54401 | 2020-07-09 |
| 1588282453 | Family Foot and Ankle Clinic LLC | Podiatrist | 1021 Western Ave Ste C, Mosinee, WI 54455-1511 | 2020-07-08 |
| 1376161240 | Family Foot and Ankle Clinic LLC | Podiatrist | 1439 Churchill St Ste 202, Waupaca, WI 54981-2089 | 2020-07-08 |
| 1083237754 | Baycare Clinic LLP | Podiatrist | 630 Riverfront Dr, Sheboygan, WI 53081-4615 | 2020-05-28 |
| 1922637107 | Torhorst Foot and Ankle Clinic, Sc | Podiatrist | 2823 Post Rd, Stevens Point, WI 54481-6416 | 2020-04-08 |
| 1528446713 | Jonathan Shih | Podiatrist | 9200 W Loomis Rd Ste 116, Franklin, WI 53132 | 2015-05-08 |
| 1912310152 | Wyatt Isaac Wiedenfeld | Podiatrist | 853 S Main St, Oconto Falls, WI 54154-1203 | 2014-06-05 |
| 1710397039 | Kristina Lorene Thompson | Podiatrist | 37868 Us-18, Prairie Du Chien, WI 53821 | 2014-05-08 |
| 1972856169 | Midwest Foot and Wound Care Center LLC | Podiatrist | W3853 Stoneridge Dr, Fond Du Lac, WI 54937-6201 | 2012-10-25 |
| 1073880936 | Tahir A Khan | Podiatrist | 6001 W Center St Ste 108, Milwaukee, WI 53210-2154 | 2011-11-21 |
| 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.