MR. RYAN KENNETH AVERETT (NPI# 1629065610) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629065610 |
| Entity Type | Individual |
| Full Name | MR. RYAN KENNETH AVERETT |
| Credential | D.P.M. |
| Practice Address |
2221 N Ironwood Center Dr Coeur D Alene ID 83814-2697 |
| Practice Telephone | 2086673585 |
| Practice Fax Number | 8558648364 |
| Mailing Telephone | 2086673585 |
| Mailing Fax Number | 8558648364 |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2016-04-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | P177 | ID | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | MEDICARE | 1351085 | 01 |
| ID | REGENCE BLUE SHIELD | 000010147409 | 01 |
| BLUE CROSS OF IDAHO | P2451 | 01 | |
| ID | 806936200 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730740051 | Ryan Averett | Specialist/Technologist | 11301 Johnson Rd, South Prince George, VA 23805-7100 | 2019-06-26 |
| 1881162600 | Ryan Christopher Averett | Chiropractor | 17 N Merchant St Ste 3, American Fork, UT 84003-1601 | 2018-11-09 |
| Street Address |
2221 N IRONWOOD CENTER DR |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83814-2697 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407047608 | Christopher R Butler Dpm P.C. | Podiatrist | 2221 N Ironwood Center Dr, Coeur D Alene, ID 83814-2697 | 2007-08-05 |
| 1659590677 | Christopher Butler | Podiatrist | 2221 N Ironwood Center Dr, Coeur D Alene, ID 83814-2697 | 2007-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477162675 | Dehra Mcfaddan | Social Worker | 211 E. Coeur D'alene Ave, 102, Coeur D Alene, ID 83814 | 2020-07-24 |
| 1043838634 | Yendi Labelle | Nurse Practitioner | 1115 N Ironwood Drive, Coeur D'alene, ID 83814 | 2020-07-09 |
| 1295353217 | Cultivation, LLC | Counselor | 211 E. Coeur Dalene Ave. Ste 102, Coeur D'alene, ID 83814 | 2020-07-07 |
| 1306487517 | Northwest Integrated Health, LLP | Clinic/Center | 1250 West N. Northwood Center Ct, Suite B, Coeur D'alene, ID 83814 | 2019-09-30 |
| 1730740465 | Connor Williams | Physical Therapist | 1812 W Lakewood Dr, Ste. 100, Coeur D Alene, ID 83814 | 2019-06-24 |
| 1912480153 | Nadine M Lewis | Social Worker | 211 E. Coeur D'alene Ave., Coeur D'alene, ID 83814 | 2018-09-13 |
| 1992208631 | Orthopedic Surgery and Sports | Orthopaedic Surgery | 1812 N Lakewood Drive, Suite 100, Coeur D'alene, ID 83814 | 2018-03-08 |
| 1346758042 | Heather Marie Johnson | Counselor | 7905 Meadowlark Way, Cda, ID 83814 | 2018-01-16 |
| 1881113413 | Brevity Treatment Services | Counselor | 2201 N. Government Way Ste. L, Coeur D'alene, ID 83814 | 2017-09-14 |
| 1366969628 | Jennifer La Gina Highfield | Massage Therapist | 1104 N Ste B, Coeur D Alene, ID 83814 | 2017-08-28 |
| Find all providers in zip 83814 | ||||
| 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 |
|---|---|---|---|---|
| 1619977972 | Stephen A Isham | Podiatrist | 101 W Ironwood Dr, Ste 131, Coeur D Alene, ID 83814-1409 | 2005-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558968750 | Family Foot and Ankle of Idaho, LLC | Podiatrist | 349 W Bacall Dr, Meridian, ID 83646-7391 | 2020-10-01 |
| 1740824762 | Idaho Complete Foot Care | Podiatrist | 880 Redman St, Chubbuck, ID 83202-2655 | 2019-11-01 |
| 1346883261 | Monarch Medical LLC | Podiatrist | 423 N 3rd Ave Ste 110, Sandpoint, ID 83864-1511 | 2019-10-23 |
| 1326496910 | Advanced Foot & Ankle of Magic Valley, Pllc | Podiatrist | 176 Falls Ave Ste 200, Twin Falls, ID 83301-2306 | 2016-05-25 |
| 1629223110 | Kyle R. Yorgason | Podiatrist | 1075 N Curtis Rd Ste 300, Boise, ID 83706-1348 | 2008-11-25 |
| 1609085455 | Craig D Holman Chartered | Podiatrist | 496 Shoup Ave W # B, Twin Falls, ID 83301-5043 | 2007-05-21 |
| 1669516738 | Valley Foot & Ankle, PC | Podiatrist | 1455 Bench Rd Ste B, Pocatello, ID 83201-5084 | 2007-02-20 |
| 1629111497 | Michael K. James | Podiatrist | 3345 S Holmes Ave, Idaho Falls, ID 83404-7981 | 2007-02-14 |
| 1790864619 | Valley Foot & Ankle, PC | Podiatrist | 1455 Bench Rd, Suite B, Pocatello, ID 83201 | 2006-11-02 |
| 1629185426 | Ronald Ray Vogel | Podiatrist | 12717 N Avondale Loop, Hayden, ID 83835-7531 | 2006-08-25 |
| Find all providers with the same taxonomy | ||||
| City | COEUR D ALENE |
| Zip Code | 83814 |
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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.