TRI-STATE PODIATRIC MEDICAL SERVICES PSC (NPI# 1750407474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750407474 |
| Entity Type | Organization |
| Organization Name | TRI-STATE PODIATRIC MEDICAL SERVICES PSC |
| Practice Address |
411 Letcher St Henderson KY 42420-4245 |
| Mailing Address |
Po Box 1593 Henderson KY 42419-1593 |
| Practice Telephone | 2708306522 |
| Mailing Telephone | 2708306522 |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2016-10-25 |
| Authorized Official Name | EDWARD G ANDERSON (PODIATRIST OWNER) |
| Authorized Official Telephone | 2708305522 |
| Authorized Official Credential | D.P.M. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | RAILROAD MEDICARE | CK6362 | 01 |
| Street Address |
411 LETCHER ST |
| City | HENDERSON |
| State | KY |
| Zip Code | 42420-4245 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366445462 | Edward Anderson | Podiatrist | 411 Letcher St, Henderson, KY 42420-4245 | 2005-05-23 |
| 1346869252 | Deaconess Clinic, Inc | Nurse Practitioner | 411 Letcher St, Henderson, KY 42420-4245 | 2020-04-10 |
| 1699335968 | Logan Scott Vansickle | Nurse Practitioner | 411 Letcher St, Henderson, KY 42420-4245 | 2019-06-18 |
| 1568957769 | Caroline M Wolverton | Family Medicine | 411 Letcher St, Henderson, KY 42420-4245 | 2018-06-29 |
| 1346494671 | Methodist Health, Inc. | Nurse Practitioner | 411 Letcher St, Henderson, KY 42420-4245 | 2008-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174136337 | Virtual Consult Md LLC | Psychiatry & Neurology | 2202 Hwy 41 North, Unit E 152, Hendereson, KY 42420 | 2020-08-27 |
| 1679062731 | Maranda Wortham Miles | Nurse Practitioner | 2242 Hwy 41 North, Henderson, KY 42420 | 2018-05-04 |
| 1780124297 | Lisa Lovell | Nurse Practitioner | 230 North Green Street, Henderson, KY 42420 | 2017-03-02 |
| 1437540614 | Kala Hovermale | Social Worker | 220 2nd Street Ste 406, Henderson, KY 42420 | 2015-02-10 |
| 1972991537 | Jessica Thomas | Counselor | 230 Second St, Suite 406, Henderson, KY 42420 | 2015-01-06 |
| 1255690962 | Green River District Health Department | Public Health or Welfare | 631 N. Green Street, Henderson, KY 42420 | 2012-05-15 |
| 1588922769 | Jonathan M Mosley | Family Medicine | 1200 Barrett Blvd, Henderson, KY 42420 | 2012-04-25 |
| 1093099731 | Gregory Ayuk | Pharmacist | 402 Second Street, Henderson, KY 42420 | 2011-09-29 |
| 1437488137 | Peter J. Doll, D.p.m. | Durable Medical Equipment & Medical Supplies | 323 8th St., Henderson, KY 42420 | 2009-12-09 |
| 1760626402 | Linda Dalton Keith | Nurse Practitioner | 1704 2nd St, Henderson, KY 42420 | 2009-04-24 |
| Find all providers in zip 42420 | ||||
| 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 |
|---|---|---|---|---|
| 1841790318 | Spencer Noorda Foot and Ankle L.L.C. | Podiatrist | 68 N Pecos Rd Ste A, Henderson, NV 89074-7340 | 2018-02-20 |
| 1306022165 | Family Foot & Ankle Center, Pa | Podiatrist | 451 Ruin Creek Rd Ste 202, Henderson, NC 27536-5920 | 2008-01-11 |
| 1144232992 | Peter James Doll | Podiatrist | 323 8th St, Henderson, KY 42420-2927 | 2006-08-12 |
| 1366445462 | Edward Anderson | Podiatrist | 411 Letcher St, Henderson, KY 42420-4245 | 2005-05-23 |
| 1922422393 | Desert Podiatry Management Inc | Podiatrist | 10624 S Eastern Ave, Suitea #423, Henderson, NV 89052-2982 | 2014-02-06 |
| 1669803193 | Spencer Keller Noorda | Podiatrist | 68 N Pecos Rd, Ste A, Henderson, NV 89074 | 2013-12-10 |
| 1104141308 | Leonard C Franklin | Podiatrist | 10561 Jeffreys St, #110, Henderson, NV 89052-4266 | 2010-03-30 |
| 1568685758 | Stuart M Feldman | Podiatrist | 8955 S Pecos Rd, Suite 2-b, Henderson, NV 89074-7156 | 2007-04-10 |
| 1811099609 | Jameson B Noorda | Podiatrist | 68 N Pecos Rd, Suite A, Henderson, NV 89074-7339 | 2006-09-02 |
| 1083630420 | Stuart M Feldman Dpm A Professional Corporation | Podiatrist | 8955 S Pecos Rd, #2-b, Henderson, NV 89074-7157 | 2006-07-15 |
| Find all providers in HENDERSON | ||||
Please comment or provide details below to improve the information on TRI-STATE PODIATRIC MEDICAL SERVICES PSC.
| 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.