JLA SENIOR FOOTCARE MO LLC (NPI# 1649587122) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649587122 |
| Entity Type | Organization |
| Organization Name | JLA SENIOR FOOTCARE MO LLC |
| Practice Address |
640 W 67th Ter Kansas City MO 64113-1945 |
| Mailing Address |
4870 S Aspen Ct Canfield OH 44406-8469 |
| Practice Telephone | 8165167453 |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2010-09-07 |
| Authorized Official Name | ANTHONY INNOCENZI (OWNER) |
| Authorized Official Telephone | 3307020978 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
1200367 | KS | Podiatric Medicine & Surgery Service Providers |
| Street Address |
640 W 67TH TER |
| City | KANSAS CITY |
| State | MO |
| Zip Code | 64113-1945 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578965216 | Kelsey Thompson | Speech-Language Pathologist | 5900 Mcgee St., Kansas City, MO 64113 | 2014-09-25 |
| 1588957088 | Kelly Burnham | Social Worker | 2 E. 59th Street, Kansas City, MO 64113 | 2011-05-17 |
| 1528270683 | Richard Abloff | Psychologist | 6306 Walnut St, Kansas City, MO 64113 | 2007-05-03 |
| 1609900075 | Jennifer Hurst | Speech-Language Pathologist | 6711 Oak St, Kansas City, MO 64113 | 2007-03-15 |
| 1972678928 | James Conrad Throckmorton | Dentist | 6309 Morningside Dr, Kansas City, MO 64113 | 2006-11-22 |
| 1538244009 | Emily Eline Hayes | Dentist | 101 E 63rd Street, Kansas City, MO 64113 | 2006-10-25 |
| 1003344276 | Restore Counseling | Counselor | 6155 Oak St Ste B, Kansas City, MO 64113 | 2017-05-31 |
| 1255418992 | Cheryl Lynn Brown | Dentist | 101 E 63rd Street, Kansas City, MO 64113 | 2006-11-01 |
| 1598842247 | Marcie C Calvin | Dentist | 101 E 63rd Street, Kansas City, MO 64113 | 2006-11-01 |
| 1013094762 | Cynthia Louise Wrehe | Dentist | 101 E 63rd Street, Kansas City, MO 64113 | 2006-11-01 |
| Find all providers in zip 64113 | ||||
| Taxonomy Code | 213ES0131X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124159439 | Harold K. Cox, Dpm & Associates, Inc. | Podiatrist | 9501 State Ave, Suite 1, Kansas City, KS 66111-1872 | 2007-03-08 |
| 1861509754 | Associated Podiatrists, P.a. | Podiatrist | 8919 Parallel Pkwy, Suite 270, Kansas City, KS 66112-1636 | 2006-08-24 |
| 1548234586 | John Riley Iv, D.p.m., P.C. | Podiatrist | 411 Nichols Rd, Suite 174, Kansas City, MO 64112-2000 | 2006-02-15 |
| 1932170610 | John J Riley Iv | Podiatrist | 411 Nichols Rd, Suite 174, Kansas City, MO 64112-2000 | 2006-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982810222 | Dr. Robert A Shemwell, Dpm | Podiatrist | 2700 Clay Edwards Dr Ste 370, N Kansas City, MO 64116-3270 | 2007-05-15 |
| 1336368745 | Foot Doctors, P.C. | Podiatrist | 929 E Montclair Stuite 100, Springfield, MO 65807-5068 | 2007-04-24 |
| 1598989428 | Robert A. Bondi, Dpm | Podiatrist | 115 Bradford Ln, Belton, MO 64012-2086 | 2007-04-12 |
| 1265588479 | Lorene Ann Van Dam | Podiatrist | 4870 W Kingsbury St, Springfield, MO 65802-7710 | 2007-01-28 |
| 1225142409 | Russell T Dirksen | Podiatrist | 929 E Montclair St, Suite 100, Springfield, MO 65807-5068 | 2006-08-18 |
| 1265545966 | Elijah Lorenzo Davis | Podiatrist | 5202 Faraon St., Ste. A, St. Joseph, MO 64506-3480 | 2006-08-16 |
| 1336154574 | Mark P Comess | Podiatrist | 1390 Hwy 61, Suite G1000, Festus, MO 63028-2612 | 2006-07-29 |
| 1790719128 | Michael Yankowitz | Podiatrist | 1216 W Main St Lowr Level, Festus, MO 63028-1654 | 2006-07-10 |
| 1083656391 | Larry Randolph Narup | Podiatrist | 8816 W Pendleton Ave, Brentwood, MO 63144-2604 | 2006-06-12 |
| 1215985940 | Betty Louise Baldridge | Podiatrist | 204 Mcmenamy Rd, St Peters, MO 63376-1514 | 2006-05-05 |
| Find all providers with the same taxonomy | ||||
| City | KANSAS CITY |
| Zip Code | 64113 |
Please comment or provide details below to improve the information on JLA SENIOR FOOTCARE MO 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.