MARYVILLE FOOT CLINIC INC (NPI# 1730101734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730101734 |
| Entity Type | Organization |
| Organization Name | MARYVILLE FOOT CLINIC INC |
| Practice Address |
1515 E Lamar Alexander Pkwy Maryville TN 37804-5131 |
| Practice Telephone | 8659822119 |
| Practice Fax Number | 8659845642 |
| Mailing Telephone | 8659822119 |
| Mailing Fax Number | 8659845642 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | MRS. BRANDI C HEGERTY (OFFICE MANAGER) |
| Authorized Official Telephone | 8656816667 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
564 | TN | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | CIGNA | 1231208 | 01 |
| TN | BCBS OF TN | 4118088 | 01 |
| TN | AETNA | 7404093 | 01 |
| TN | 3732878 | 05 | |
| TN | UNITED HEALTHCARE | BNA2743006 | 01 |
| TN | JOHN DEERE | TN0101 | 01 |
| Street Address |
1515 E LAMAR ALEXANDER PKWY |
| City | MARYVILLE |
| State | TN |
| Zip Code | 37804-5131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659835825 | Matthew David Mallory | Physical Therapist | Morning View Village 2320 E. Lamar Alexander Parway, Maryville, TN 37804 | 2019-01-22 |
| 1063937290 | Rachel Ryan Mcmillan | Counselor | 362 High Street, Maryville, TN 37804 | 2017-08-09 |
| 1316461460 | Steven Casey Boring | Nurse Practitioner | 907 E. Lamar Alexander Pkwy., Maryville, TN 37804 | 2017-07-31 |
| 1851738751 | Robert Kane Mccall | Pathology | 250 E. Broadway, Maryville, TN 37804 | 2013-05-31 |
| 1619242849 | Jennifer Mcclements | Physical Therapy Assistant | 4004 Samuel Circle, Maryville, TN 37804 | 2012-03-21 |
| 1316223886 | Sabrina Nicole Powers | Social Worker | 1704 East Broadway, Maryville, TN 37804 | 2011-10-28 |
| 1407138381 | Russmann, Inc. | Ambulance | 4163 Benny Delozier Drive, Maryville, TN 37804 | 2011-09-15 |
| 1184932485 | Complete Family Care of Maryville, Pllc | Internal Medicine | 2004 E. Broadway, Maryville, TN 37804 | 2010-09-21 |
| 1093975096 | Kristi Clark Correll | Speech-Language Pathologist | 2030 East Lamar Alexander Parkway, Maryville, TN 37804 | 2008-06-12 |
| 1134388267 | Barbara Frantz Poulsen | Speech-Language Pathologist | 2030 E Lamar Alexander Parkway, Maryville, TN 37804 | 2008-06-04 |
| Find all providers in zip 37804 | ||||
| Taxonomy Code | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366619199 | Paul W. Hutchison | Podiatrist | 1723 Highway 51 S Ste C, Covington, TN 38019-3628 | 2008-05-12 |
| 1891914545 | Michael Warren Lawrence | Podiatrist | 1018 Dallas Rd Ste 304, Chattanooga, TN 37405-2707 | 2007-04-24 |
| 1093838187 | Paul William Hutchison, Dpm | Podiatrist | 7878 Winchester Road, Memphis, TN 38125 | 2007-04-06 |
| 1548304405 | Richard S. Eby | Podiatrist | 3603 E Ringgold Rd, Chattanooga, TN 37412-1247 | 2007-02-16 |
| 1841308244 | Joseph Bernard Neubauer | Podiatrist | 1719 Wiltshire Dr, Murfreesboro, TN 37129-1085 | 2006-08-26 |
| 1568473320 | Robert J Schreiber | Podiatrist | 1705 Wedgewood Dr, Columbia, TN 38401-3529 | 2006-08-10 |
| 1750305892 | Gary Marc Mantell | Podiatrist | 5180 Park Ave Ste 220, Memphis, TN 38119-3530 | 2006-07-26 |
| 1760410260 | Robert Tucker Spalding Jr. | Podiatrist | 1225 Taft Hwy, Signal Mountain, TN 37377-3251 | 2006-06-30 |
| 1588616098 | Mark B Hellmann | Podiatrist | 1855 Tanner Way Ste 130, Harriman, TN 37748-8331 | 2006-05-16 |
| 1043207988 | Vincent B Longobardo | Podiatrist | 19 Miracle Ln, Suite 200, Crossville, TN 38555-7654 | 2005-10-05 |
| 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.