CLARKE PODIATRY, LLC (NPI# 1790295228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790295228 |
Entity Type | Organization |
Organization Name | CLARKE PODIATRY, LLC |
Practice Address |
113 S Main St Milton Freewater OR 97862-1342 |
Mailing Address |
Po Box 687 Milton Freewater OR 97862-0687 |
Practice Telephone | 5417862321 |
Practice Fax Number | 5418544020 |
Mailing Telephone | 5417862321 |
Mailing Fax Number | 5418544020 |
Enumeration Date | 2017-10-11 |
Last Update Date | 2018-06-16 |
Authorized Official Name | DR. STACEY J. CLARKE (OWNER) |
Authorized Official Telephone | 5417862321 |
Authorized Official Credential | DPM |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
DP00283 | OR | Podiatric Medicine & Surgery Service Providers |
Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
DP00283 | OR | Podiatric Medicine & Surgery Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OR | 150541 | 05 | |
OR | BLUE CROSS BLUE SHIELD | 6805300 | 01 |
OR | DEA | BC4203408 | 01 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Oregon Corporations, Companies and Business Names | CLARKE PODIATRY, LLC | Po Box 329, Imbler, OR 97841 |
Street Address |
113 S MAIN ST |
City | MILTON FREEWATER |
State | OR |
Zip Code | 97862-1342 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538627062 | Atlantic Home Health Care, LLC | Home Health | 113 S Main St, Milton Freewater, OR 97862-1342 | 2019-03-04 |
1134570948 | Julie Medrano | Counselor | 113 S Main St, Milton Freewater, OR 97862-1342 | 2016-06-23 |
1013331479 | Dynamic Edge Physical Therapy LLC | Clinic/Center | 113 S Main St, 113 S. Main, Milton Freewater, OR 97862-1342 | 2014-02-05 |
1710075619 | Manford E. Anliker | Physical Therapist | 113 S Main St, Milton Freewater, OR 97862-1342 | 2006-10-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528538352 | Paksupim Cole | Massage Therapist | 85452 Hwy 11, Milton Freewater, OR 97862 | 2018-12-05 |
1356812192 | Lacey Elizabeth Rose Klem | Massage Therapist | 85458 Hywy 11, Milton Freewater, OR 97862 | 2018-12-05 |
1770778664 | Amon Chiropractic LLC | Chiropractor | 85458 Hwy 11, Milton Freewater, OR 97862 | 2007-09-13 |
1215001052 | Broadway Family Dental Care LLC | Dentist | 508 E Broadway, Milton Freewater, OR 97862 | 2006-11-20 |
1750462917 | Sarah S Hsu | Social Worker | 1253 Stonewood Ct, Milton Freewater, OR 97862 | 2006-10-17 |
1548890916 | Divine Mansiba Maganto | Nurse's Aide | 1010 Ne 3rd Ave, Milton Freewater, OR 97862 | 2020-01-24 |
1902317621 | Michael David Bruno | Speech-Language Pathologist | 120 Elzora St, Milton Freewater, OR 97862 | 2017-10-20 |
1821475286 | Danielle Strickland | Massage Therapist | 533 S Main St, Milton Freewater, OR 97862-1017 | 2015-05-05 |
1457476392 | Alicia A Taylor | Registered Nurse | 110 Sw 4th Ave, Milton Freewater, OR 97862-1031 | 2007-03-20 |
1225401151 | Serenity Counseling PC | Community/Behavioral Health | 1253 Stonewood Ct, Milton Freewater, OR 97862-1067 | 2015-10-30 |
Find all providers in zip 97862 |
Taxonomy Code | 213ES0103X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
Specialization | Foot & Ankle Surgery |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003432204 | Frontier Foot and Ankle Specialists LLC | Podiatrist | 780 2nd St Se # 10, Bandon, OR 97411-8354 | 2020-06-23 |
1710436662 | Hermiston Family Foot Clinic LLC | Podiatrist | 1050 W Elm Ave Ste 170, Hermiston, OR 97838-2715 | 2016-10-03 |
1255784492 | Sunny Sajjad | Podiatrist | 4905 River Rd N, Keizer, OR 97303-4539 | 2016-07-22 |
1285080556 | Sean Westover | Podiatrist | 1227 Ne 7th St Ste A, Grants Pass, OR 97526-1430 | 2016-05-05 |
1659774792 | Heather Keeler | Podiatrist | 1880 Willamette Falls Dr Ste 111, West Linn, OR 97068-4653 | 2014-10-03 |
1386051803 | Southwest Podiatry Center LLC | Podiatrist | 9370 Sw Greenburg Rd Ste 102, Portland, OR 97223-5428 | 2014-07-16 |
1578980694 | Amy Theppote | Podiatrist | 6542 Se Lake Rd Ste 102, Milwaukie, OR 97222-2245 | 2014-03-26 |
1144576224 | Trevor J Haynes | Podiatrist | 39400 Pioneer Blvd Ste 4, Sandy, OR 97055-8000 | 2012-07-26 |
1922379379 | John S Balknap Dpm PC | Podiatrist | 1716 E 12th St, The Dalles, OR 97058-3137 | 2012-01-17 |
1407145568 | Justin T Johnson Dpm Inc. | Podiatrist | 1661 Hwy 99 N Ste 201, Ashland, OR 97520-8900 | 2011-03-29 |
Find all providers with the same taxonomy |
City | MILTON FREEWATER |
Zip Code | 97862 |
Please comment or provide details below to improve the information on CLARKE 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.