EVANSTON FAMILY FOOT CARE (NPI# 1700060902) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700060902 |
| Entity Type | Organization |
| Organization Name | EVANSTON FAMILY FOOT CARE |
| Practice Address |
1565 Highway 150 South Suite C Evanston WY 82930-5348 |
| Mailing Address |
Po Box 238 Evanston WY 82931-0238 |
| Practice Telephone | 3077898997 |
| Practice Fax Number | 3077892624 |
| Mailing Telephone | 3077898997 |
| Mailing Fax Number | 3077892624 |
| Enumeration Date | 2007-12-24 |
| Last Update Date | 2008-01-06 |
| Authorized Official Name | DR. JASON CANNON LEVITRE (PODIATRIST) |
| Authorized Official Telephone | 3077898997 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
127 | WY | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 1217844 00 | 05 | |
| WY | RAILROAD MEDICARE | DD8254 | 01 |
| Street Address |
1565 HIGHWAY 150 SOUTH SUITE C |
| City | EVANSTON |
| State | WY |
| Zip Code | 82930-5348 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598398935 | Colby Kim Gomez | Physical Therapist | 190 Arrowhead Dr, Evanston, Wy 82930, Evanston, WY 82930 | 2020-02-13 |
| 1164808382 | Marilyn Carol Edgeworth Tacoma | Registered Nurse | 1037 Morse Lee St, Evanston, WY 82930 | 2015-08-11 |
| 1699159723 | Impact Physical Therapy LLC | Clinic/Center | 96 Yellow Creek Road, Evanston, WY 82930 | 2015-07-18 |
| 1578942421 | Mark Carstensen | Case Manager/Care Coordinator | 219 7th Street, Evanston, WY 82930 | 2015-05-26 |
| 1013396241 | Jennifer Carstensen | Case Manager/Care Coordinator | 325 Arrowhead Drive, Evanston, WY 82930 | 2015-05-20 |
| 1780083782 | Christa Lena Barker | Nurse Practitioner | 191 Overthrust Road, Evanston, WY 82930 | 2014-08-15 |
| 1366865339 | Don Mckay Francom | Dentist | 170 Arrowhead Dr. Suite 1, Evanston, WY 82930 | 2014-01-28 |
| 1417228370 | Premier Surgical Center, LLC | Clinic/Center | 195 Overthrust Road, Evanston, WY 82930 | 2012-01-24 |
| 1588959324 | Mejia D Williams | Social Worker | 190 Overthrust Road, Evanston, WY 82930 | 2011-06-09 |
| 1225327000 | Richard Jay Capener | Family Medicine | 196 Arrowhead Dr Ste 1, Evanston, WY 82930 | 2011-04-01 |
| Find all providers in zip 82930 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427411669 | Samantha Lauren Jensen | Podiatrist | 2809 Garrison Ave, Evanston, IL 60201-1775 | 2016-04-04 |
| 1780050195 | Zubair Ali Khan | Podiatrist | 2500 Ridge Ave Ste 110, Evanston, IL 60201 | 2015-08-19 |
| 1023404514 | Utah Podiatry Group PC | Podiatrist | 191 Overthrust Rd, Evanston, WY 82930-9261 | 2015-04-10 |
| 1265877849 | Samantha Dolph Winerman | Podiatrist | 2500 Ridge Ave, Ste 110, Evanston, IL 60201-2455 | 2013-05-08 |
| 1033481627 | Kari Leann Chase | Podiatrist | 2500 Ridge Ave, Suite #110, Evanston, IL 60201-2455 | 2012-01-30 |
| 1477820280 | Chicago Foot and Ankle, LLC | Podiatrist | 355 Ridge Ave, Proffesional Building West Tower, Suite 604, Evanston, IL 60202-3328 | 2011-11-22 |
| 1467676536 | Aaa Foot & Ankle Associates | Podiatrist | 800 Austin St, Suite#469, Evanston, IL 60202-3439 | 2007-04-12 |
| 1205885274 | Kevin John Tunnat | Podiatrist | 800 Austin St, Suite #611, Evanston, IL 60202-3439 | 2006-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801286778 | Five Star Feet, LLC | Podiatrist | 2525 Road 218, Cheyenne, WY 82009-9103 | 2015-01-30 |
| 1992820781 | Rick B Roper | Podiatrist | 2029 Bluegrass Circle, Suite 2, Cheyenne, WY 82009-7369 | 2007-03-20 |
| 1518037043 | Eric M Dash | Podiatrist | 1916 E 1st St, Suite 1, Casper, WY 82601-2777 | 2006-11-09 |
| 1760824502 | Advanced Foot Care | Podiatrist | 1303 E Grand Ave, Laramie, WY 82070-4137 | 2013-07-22 |
| 1568710598 | The Foot Clinic LLC | Podiatrist | 1916 E 1st St, Casper, WY 82601-2777 | 2012-08-23 |
| 1639459068 | Jason K Kane | Podiatrist | 132 N Gould St, Sheridan, WY 82801-3928 | 2011-08-17 |
| 1003050253 | Big Horn Foot Clinic, PC | Podiatrist | 424 Yellowstone Ave, Suite 140, Cody, WY 82414-9318 | 2009-04-30 |
| 1922241181 | Lael J. Beachler | Podiatrist | 777 Avenue H, Powell, WY 82435-2260 | 2009-04-16 |
| 1912057290 | Aaron Deane Donaldson | Podiatrist | 1005 College View Dr, Riverton, WY 82501-2266 | 2007-01-11 |
| 1497857262 | Tyler Ann Marshall | Podiatrist | 2360 E Pershing Blvd, Cheyenne, WY 82010-0001 | 2006-09-02 |
| 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.