MONTICELLO PODIATRY LLC (NPI# 1780048108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780048108 |
| Entity Type | Organization |
| Organization Name | MONTICELLO PODIATRY LLC |
| Other Organization Name | LOGANSPORT PODIATRY |
| Practice Address |
101 W Broadway St Monticello IN 47960-2110 |
| Practice Telephone | 8446873338 |
| Practice Fax Number | 8446873338 |
| Mailing Telephone | 8446873338 |
| Mailing Fax Number | 8446873338 |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2016-04-12 |
| Authorized Official Name | DR. MURTUZA ALI PEERBHAI (PRESIDENT) |
| Authorized Official Telephone | 7654306963 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | Y |
| Parent Organization Name | MONTICELLO PODIATRY LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
07001110A | IN | Podiatric Medicine & Surgery Service Providers |
| Other Name | Type Code |
|---|---|
| logansport podiatry | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154626661 | Monticello Podiatry LLC | Clinic/Center | 101 W Broadway St, Monticello, IN 47960-2110 | 2011-01-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | MONTICELLO PODIATRY LLC | 1305 Palmer Drive Apt 311, West Lafayette, IN 47906 |
| Street Address |
101 W BROADWAY ST |
| City | MONTICELLO |
| State | IN |
| Zip Code | 47960-2110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740316124 | Murtuza A. Peerbhai | Podiatrist | 101 W Broadway St, Apartment 311, Monticello, IN 47960-2110 | 2007-02-27 |
| 1154626661 | Monticello Podiatry LLC | Clinic/Center | 101 W Broadway St, Monticello, IN 47960-2110 | 2011-01-13 |
| 1649453085 | Ellsworth P Grubbs | Durable Medical Equipment & Medical Supplies | 101 W Broadway St, Monticello, MN 55362-9352 | 2007-12-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255743472 | Suzanne Reber | Pharmacist | 4901 Sr 26th E, Lafayette, IN 47960 | 2014-05-22 |
| 1588075949 | Theodore Eckerle | Social Worker | 920 West Executive Court, Monticello, IN 47960 | 2014-05-19 |
| 1598805723 | Twin Lakes School Corporation | Local Education Agency (LEA) | 565 S Main Street, Monticello, IN 47960 | 2007-02-07 |
| 1003904806 | Forest Richard Robertson II | Dentist | 515 S Illinois St, Monticello, IN 47960 | 2006-10-10 |
| 1447345889 | Linda Jean Feuquay | Counselor | 207 N. Bluff St., Monticello, IN 47960 | 2006-10-03 |
| 1548270697 | Cdc Resources Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5053 Norway Rd, Monticello, IN 47960 | 2006-08-09 |
| 1528040516 | The Eye Center Group LLC | Optometrist | 1101 O'connor Blvd, Monticello, IN 47960 | 2005-11-16 |
| 1861489254 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 1120 N Main St, Monticello, IN 47960 | 2005-09-30 |
| 1467890293 | White County Community Counseling Services LLC | Counselor | 126 S Main St, Monticello, IN 47960 | 2013-06-14 |
| 1144589813 | Angelique Witlam | Physical Therapist | 906 W. Executive Court, Monticello, IN 47960 | 2012-05-15 |
| Find all providers in zip 47960 | ||||
| Taxonomy Code | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447784012 | Mohammed Ahmeduddin, LLC | Podiatrist | 11661 Archer Ln, Fishers, IN 46037-3201 | 2017-04-20 |
| 1306295084 | Melanie S. Kocevar | Podiatrist | 2003 Stults Rd Ste 200, Huntington, IN 46750-1291 | 2016-06-03 |
| 1457732133 | Angelic Footcare | Podiatrist | 8785 Keystone Xing, 1268, Indianapolis, IN 46240-2337 | 2015-06-17 |
| 1528317518 | Jerwana Laster | Podiatrist | 10935 Beechwood Dr E, Indianapolis, IN 46280-1222 | 2012-09-05 |
| 1881955664 | Manjit Kaur | Podiatrist | 301 Satori Pkwy Ste 150, Avon, IN 46123-6408 | 2012-06-07 |
| 1922240019 | Robert E. Wyatt | Podiatrist | 9134 Bradenton Rd, Fort Wayne, IN 46835-8892 | 2009-04-03 |
| 1801066691 | Dr. Thomas V. Tsoutsouris | Podiatrist | 1403 Franklin St, Michigan City, IN 46360-3707 | 2008-03-07 |
| 1285804070 | Dr. Thomas V. Tsoutsouris | Podiatrist | 7330 Indianapolis Blvd Ste 3, Hammond, IN 46324-2945 | 2008-03-07 |
| 1003099441 | Lafayette Foot and Ankle Clinic | Podiatrist | 2700 Lafayette St Ste 230, Fort Wayne, IN 46806-1100 | 2007-12-07 |
| 1376749168 | Srd Podiatry P.C. | Podiatrist | 1237 W. 82nd Lane, Merrillville, IN 46410 | 2007-06-27 |
| Find all providers with the same taxonomy | ||||
| City | MONTICELLO |
| Zip Code | 47960 |
Please comment or provide details below to improve the information on MONTICELLO PODIATRY LLC.
| 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.