DR. SALLY CARABALLO (NPI# 1659363471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1659363471 |
Entity Type | Individual |
Full Name | DR. SALLY CARABALLO |
Credential | D.P.M. |
Practice Address |
55 N Central Ave Suite 3 Fairborn OH 45324-5087 |
Practice Telephone | 9378782800 |
Practice Fax Number | 9378787261 |
Mailing Telephone | 9378782800 |
Mailing Fax Number | 9378787261 |
Enumeration Date | 2005-08-18 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
2815 | OH | Podiatric Medicine & Surgery Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OH | 0173726 | 05 |
Street Address |
55 N CENTRAL AVE SUITE 3 |
City | FAIRBORN |
State | OH |
Zip Code | 45324-5087 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023647591 | Michael Hubbell | Student in an Organized Health Care Education/Training Program | 2555 University Blvd., Fairborn, OH 45324 | 2020-04-06 |
1982243382 | Wickshire Fairborn Opco LLC | Assisted Living Facility | 2270 Park Hills Drive, Fairborn, OH 45324 | 2020-01-02 |
1104301654 | Sophia Alridge | Counselor | 594 East Dayton Yellow Springs Road, Fairborn, OH 45324 | 2018-10-01 |
1750863189 | Sydney Bowser | Behavior Technician | 1750 Commerce Center Blvd., Fairborn, OH 45324 | 2018-09-01 |
1710406798 | Chester Cashmir Torkornoo | Dentist | 3989 Colonel Glenn Hwy A, Fairborn, OH 45324 | 2017-09-11 |
1245772375 | Ranada LLC | Health Maintenance Organization | 17 Vanderbilt Drive Apt G, Fairborn, OH 45324 | 2016-11-07 |
1194277582 | Derrick Bark | Specialist/Technologist | 85 Old Yellow Springs Rd, Fairborn, OH 45324 | 2016-11-01 |
1326592635 | Sheena Elizabeth Geoghegan | Student in an Organized Health Care Education/Training Program | 725 Univerisity Blvd., Wright State Physicians, Fairborn, OH 45324 | 2016-08-04 |
1912360199 | Tarah Heath | Occupational Therapist | 2498 Dayton, Beavercreek, OH 45324 | 2016-04-04 |
1255706339 | Cierra Jackson | Counselor | 1560 Calder Ct, Fairborn, OH 45324 | 2015-12-01 |
Find all providers in zip 45324 |
Taxonomy Code | 213EP1101X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
Specialization | Primary Podiatric Medicine |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023361318 | Lara S Poduska Dpm LLC | Podiatrist | 24816 Aurora Rd Ste A, Bedford Heights, OH 44146-6908 | 2012-10-24 |
1598037467 | David L. Beatty Dpm PC | Podiatrist | 125 N Water St, Paulding, OH 45879-1245 | 2012-02-07 |
1750677829 | Elizabeth Gero | Podiatrist | 10701 East Blvd # 112bw, Cleveland, OH 44106-1702 | 2011-06-27 |
1841433703 | Home Visit Podiatrists, Inc. | Podiatrist | 2010 Wayland Ave, Cincinnati, OH 45212-3708 | 2009-04-08 |
1023250248 | Podiatry Home Health Care | Podiatrist | 5683 Pearl Rd, Parma, OH 44129-2528 | 2009-04-02 |
1982850525 | Richard A Raabe Dpm Inc | Podiatrist | 128 Wertz Ave Nw Ste A, Canton, OH 44708 | 2008-08-14 |
1225214125 | Louis L. Endress Dpm | Podiatrist | 2914 Cleveland Rd, Wooster, OH 44691-1655 | 2008-01-10 |
1457533622 | James D. Robinette, Dpm, Inc. | Podiatrist | 5932 Colerain Ave, Cincinnati, OH 45239-6414 | 2007-11-29 |
1336352038 | Laser Foot Care Center, Inc | Podiatrist | 2495 Olentangy Dr, Akron, OH 44333-2831 | 2007-05-08 |
1932237922 | Thomas Joseph Javorsky | Podiatrist | 1400 S Hubbard Rd, Lowellville, OH 44436-9411 | 2007-03-01 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on DR. SALLY CARABALLO.
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.