DR. JESSE ANDERSON III (NPI# 1770583080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770583080 |
| Entity Type | Individual |
| Full Name | DR. JESSE ANDERSON III |
| Credential | DPM |
| Practice Address |
2401 Godwin Blvd Ste 1 Suffolk VA 23434-8178 |
| Practice Telephone | 7576252962 |
| Practice Fax Number | 7576279861 |
| Mailing Telephone | 7576252962 |
| Mailing Fax Number | 7576279861 |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2011-07-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 0103000709 | VA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | LIC | 0103000709 | 01 |
| VA | DEA | BA0471362 | 01 |
| VA | OPTIMA | 62841 | 01 |
| VA | ANTHEM | 282441 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609403112 | Jesse Anderson | Social Worker | 1303c Nicholas St, Easton, PA 18045 | 2020-03-25 |
| 1538661186 | Jesse Anderson | Specialist/Technologist | 102 Iverson St W, Saint Joseph, MN 56374-4650 | 2018-02-28 |
| 1518368836 | Jesse Anderson | Chiropractor | 982 N Taylor St, Green Bay, WI 54303-1202 | 2014-09-05 |
| 1164710349 | Jesse Lee Anderson | Physical Therapist | 30 Lawrence Rd Ste 900, Broomall, PA 19008-3301 | 2011-07-21 |
| 1750916763 | Jesse Michael Anderson | Physician Assistant | 35 State Ave Ste 1, Faribault, MN 55021-6369 | 2020-03-10 |
| 1578069340 | Jesse Paul Anderson | Behavioral Analyst | 102 Westlake Dr, West Lake Hills, TX 78746-5394 | 2018-04-02 |
| 1629580436 | Jesse Anderson | Orthopaedic Surgery | 18444 N 25th Ave Ste 210, Phoenix, AZ 85023 | 2017-11-02 |
| 1104378215 | Jesse Ward Anderson | Physician Assistant | 207 Foote Ave, Jamestown, NY 14701-7077 | 2016-10-25 |
| 1720333628 | Jesse Willis Anderson | Registered Nurse | 2789 Ortiz Ave, Fort Myers, FL 33905-7806 | 2012-07-17 |
| 1497835474 | Jesse Anderson | Pharmacy Technician | 1001 N Country Club Rd, Ada, OK 74820-2847 | 2006-10-16 |
| Street Address |
2401 GODWIN BLVD STE 1 |
| City | SUFFOLK |
| State | VA |
| Zip Code | 23434-8178 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235780255 | Chiquita Savage | Home Health | You 1st Healthcare, 112 West Washington Street Suite 502, Suffolk, VA 23434 | 2019-09-20 |
| 1912561713 | Revivication Counseling Services | Counselor | 814 Cripple Creek Lane, Suffolk, VA 23434 | 2019-04-26 |
| 1558826958 | Nita Jenkins | Non-emergency Medical Transport (VAN) | 707 Gittings St. Suite 105, Suffolk, VA 23434 | 2019-02-10 |
| 1730660952 | Latrese L Riddick | Driver | 418 Jackson St, Suffolk, VA 23434 | 2018-08-25 |
| 1114411279 | Percilla D Zeno | Community Health Worker | 102 Niblick Cir, Suffolk, VA 23434 | 2018-06-21 |
| 1437652765 | Aprele Gaddie | Health Educator | 2769 Godwin Boulevard, Suffolk, VA 23434 | 2018-03-13 |
| 1598284283 | Domonic Teheran Scott | Driver | 102 Brewer Ave, Suffolk, VA 23434 | 2017-09-13 |
| 1578089397 | Nakia Shantel Francis | Nurse Practitioner | 2970 Godwin Blvd, Suite 320, Suffolk, VA 23434 | 2017-08-15 |
| 1679093009 | Daisy Mae Aba, LLC | Behavioral Analyst | 3212 Clearcreek Rd., Suffolk, VA 23434 | 2017-06-27 |
| 1114457736 | Better Care Family Homes | Day Training, Developmentally Disabled Services | 813 West Washington Street, Suffolk, VA 23434 | 2017-06-15 |
| Find all providers in zip 23434 | ||||
| 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 |
|---|---|---|---|---|
| 1427105949 | 1foot 2foot Centre for Foot and Ankle Care, PC | Podiatrist | 171 North Main Street, Suffolk, VA 23434 | 2007-01-05 |
| 1215922562 | Jason Noah Choos | Podiatrist | 3907 Bridge Rd Ste 101, Suffolk, VA 23435-1133 | 2005-09-13 |
| 1497748628 | George Madison Long Jr. | Podiatrist | 2401 Godwin Blvd, Ste 1, Suffolk, VA 23434-8178 | 2005-08-23 |
| 1639175334 | Gerald D Scheimberg | Podiatrist | 707 Gittings St, Ste 140, Suffolk, VA 23434-6101 | 2005-06-27 |
| 1831450436 | Jeremy Walters | Podiatrist | 150 Burnetts Way Ste 100, Suffolk, VA 23434-8168 | 2012-05-31 |
| 1154416352 | Marc A Barbella | Podiatrist | 171 N Main St, Suffolk, VA 23434-4507 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255972543 | Achilles Foot Ankle Center Inc | Podiatrist | 681 Hioaks Rd Ste D, Richmond, VA 23225-4043 | 2019-10-08 |
| 1780225078 | Achilles Foot Ankle Center Inc | Podiatrist | 100 Winters St Ste 106, West Point, VA 23181-9534 | 2019-10-08 |
| 1699331710 | Foot and Ankle Specialists of The Mid-atlantic, LLC | Podiatrist | 2210 Executive Dr Ste E, Hampton, VA 23666-6605 | 2019-05-14 |
| 1215419015 | Foot and Ankle Specialists of The Mid-atlantic, LLC | Podiatrist | 530 Sunset Ln Ste A, Culpeper, VA 22701-3981 | 2018-08-29 |
| 1942782743 | Foot and Ankle Specialists of The Mid-atlantic, LLC | Podiatrist | 66 Parkway Ln Ste 102, Fishersville, VA 22939-2385 | 2018-08-29 |
| 1982151577 | Complete Care Medical Group LLC | Podiatrist | 41 Peach Grove Ln, Montross, VA 22520-2756 | 2016-09-01 |
| 1245694488 | Kevin David Rabie | Podiatrist | 3720 Holland Rd Ste 100, Virginia Beach, VA 23452-2859 | 2016-04-13 |
| 1093191280 | Lisa Morse | Podiatrist | 174 Todds Creek Ln, Mathews, VA 23109-2144 | 2015-08-11 |
| 1548642788 | Justin Andrew Phillingane | Podiatrist | 3335 S Crater Rd Ste 500, Petersburg, VA 23805 | 2015-06-24 |
| 1770990764 | Ribeiro Foot and Ankle Center | Podiatrist | 4660 Kenmore Ave Ste 602, Alexandria, VA 22304-1300 | 2014-07-22 |
| 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.