DR. SHELLY DIANE SEDBERRY (NPI# 1770978074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770978074 |
| Entity Type | Individual |
| Full Name | DR. SHELLY DIANE SEDBERRY |
| Credential | D.P.M. |
| Practice Address |
1801 W 32nd St Bldg C Joplin MO 64804 |
| Mailing Address |
Po Box 4427 Joplin MO 64803-4427 |
| Practice Telephone | 4058198013 |
| Mailing Telephone | 4176220648 |
| Mailing Fax Number | 4176220497 |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2020-04-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
2018010120 | MO | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
12-00438 | KS | Podiatric Medicine & Surgery Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1000 Mulberry St, Independence, KS 673012026 | 8475045000 | 8475045015 |
| Street Address |
1801 W 32ND ST BLDG C |
| City | JOPLIN |
| State | MO |
| Zip Code | 64804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033718903 | Lisa Jo Moore | Nurse Practitioner | 2623 S Main Street, Nixa, MO 64804 | 2020-10-22 |
| 1346859600 | Centered and Connected LLC | Counselor | 2401 E 32nd St, Ste 10 #103, Joplin, MO 64804 | 2020-07-23 |
| 1649838780 | Nicole Lynn Egan | Social Worker | 3010 Mcclelland, Joplin, MO 64804 | 2019-06-04 |
| 1902361652 | Redings Mill Internal Care | Clinic/Center | 454 Redings Mill Rd, Joplin, MO 64804 | 2019-02-06 |
| 1447732508 | Urgent Care Travel, Inc | Clinic/Center | 5931 E 32nd Street, Joplin, MO 64804 | 2018-09-05 |
| 1912488891 | Karl G. Keczkemethy | Dietitian, Registered | 100 Mercy Way Ste 570, Joplin, MO 64804 | 2018-08-28 |
| 1790207546 | Jacksie Short | Dentist | 2819 E 29th St, Joplin, MO 64804 | 2017-07-13 |
| 1326574625 | Kristine Kwon Rowland | Nurse Practitioner | 100 Mercy Way Ste 320-330, Joplin, MO 64804 | 2017-05-05 |
| 1942735212 | West R Loveland | Counselor | 3230 S Wisconsin St Suite H, Joplin, MO 64804 | 2017-04-25 |
| 1174070205 | Tracy L Fry | Nurse Practitioner | 3333 Mcintosh Cir Ste 4, Joplin, MO 64804 | 2016-09-07 |
| Find all providers in zip 64804 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750853313 | Shoal Creek Foot and Ankle Center LLC | Podiatrist | 1801 W 32nd St Ste 102, Joplin, MO 64804-1528 | 2018-12-20 |
| 1346722055 | Shoal Creek Foot and Ankle Center LLC | Podiatrist | 1801 W 32nd St Ste 102, Joplin, MO 64804-1528 | 2018-08-30 |
| 1104288141 | Brittany Marie-noelle Ciaramello | Podiatrist | 1801 W 32nd St Ste 102, Joplin, MO 64804-1528 | 2016-03-28 |
| 1194017996 | Jared A Stanton | Podiatrist | 100 Mercy Way, Suite 420, Joplin, MO 64804-4524 | 2011-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851923023 | Center for Advanced Foot & Ankle Surgery, Inc. | Podiatrist | 3915 Watson Rd Ste 200, Saint Louis, MO 63109-1251 | 2020-02-06 |
| 1518486885 | Sunflower Podiatry and Wellness | Podiatrist | 1316 Hebert Street, Saint Louis, MO 63107 | 2017-09-18 |
| 1144753492 | Creighton Woolsey | Podiatrist | 1155 W Parkview St Ste 2j, Bolivar, MO 65613-8598 | 2017-04-04 |
| 1457701559 | Robert Austin Djali | Podiatrist | 1224 Graham Rd Ste 3010, Florissant, MO 63031-8028 | 2016-06-20 |
| 1376936591 | Corey Bess | Podiatrist | 1010 Carondelet Dr Ste 301, Kansas City, MO 64114 | 2015-03-12 |
| 1093117335 | True Health Integration and Synergy | Podiatrist | 6311 Ronald Reagan Dr, #167, Lake St Louis, MO 63367-2681 | 2014-09-18 |
| 1710305677 | Kevin M Renner | Podiatrist | 225 Physicians Park Ste 102, Poplar Bluff, MO 63901-3918 | 2014-03-28 |
| 1134474554 | Rajan K Patel | Podiatrist | 3930 S Jackson Dr, Apt 308, Independence, MO 64057-1706 | 2012-07-23 |
| 1720346307 | Feet for Life Centers Inc PC | Podiatrist | 17201 Chesterfield Airport Rd, Chesterfield, MO 63005-1423 | 2012-05-02 |
| 1669745501 | West County Foot and Ankle LLC | Podiatrist | 10004 Kennerly Rd Ste 300a, Saint Louis, MO 63128 | 2012-02-22 |
| 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.