WASHTENAW PODIATRY GROUP, LLC (NPI# 1801276274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801276274 |
| Entity Type | Organization |
| Organization Name | WASHTENAW PODIATRY GROUP, LLC |
| Practice Address |
3145 W Clark Rd Suite 201 Ypsilanti MI 48197-1120 |
| Practice Telephone | 7345721141 |
| Practice Fax Number | 7345721142 |
| Mailing Telephone | 7345721141 |
| Mailing Fax Number | 7345721142 |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2015-06-01 |
| Authorized Official Name | MARK J KLEIN (OWNER) |
| Authorized Official Telephone | 7345721141 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers | ||
| Y | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers |
| Street Address |
3145 W CLARK RD SUITE 201 |
| City | YPSILANTI |
| State | MI |
| Zip Code | 48197-1120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962408161 | Fayek Nicholas Shamma | Obstetrics & Gynecology | 3145 W Clark Rd, Ste 301, Ypsilanti, MI 48197-1120 | 2005-06-22 |
| 1578011615 | Justin Diebold | Physical Therapist | 3145 W Clark Rd, Suite 102, Ypsilanti, MI 48197-1120 | 2016-09-19 |
| 1588112619 | Ronald P. Adelman Dpm Pllc | Podiatrist | 3145 W Clark Rd, #201, Ypsilanti, MI 48197-1120 | 2016-09-19 |
| 1548717713 | Charlotte Cahill | Physical Therapist | 3145 W Clark Rd, 106, Ypsilanti, MI 48197-1120 | 2016-09-06 |
| 1699149997 | Patricia Watkins | Registered Nurse | 3145 W Clark Rd, Suite 303, Ypsilanti, MI 48197-1120 | 2015-11-24 |
| 1316321136 | Nathan Kangas | Physical Therapist | 3145 W Clark Rd, Ste 102, Ypsilanti, MI 48197-1120 | 2015-07-10 |
| 1689061467 | Chelsea Professional Services | Internal Medicine | 3145 W Clark Rd, Suite 401, Ypsilanti, MI 48197-1120 | 2015-04-20 |
| 1346632106 | Kevern Hartmann | Physical Therapist | 3145 W Clark Rd, Suite 102, Ypsilanti, MI 48197-1120 | 2015-03-03 |
| 1952793804 | Cara House | Physical Therapist | 3145 W Clark Rd, Ypsilanti, MI 48197-1120 | 2015-03-02 |
| 1770975088 | Leanne Camara | Physical Therapist | 3145 W Clark Rd, Ste 102, Ypsilanti, MI 48197-1120 | 2015-02-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700423092 | Devika Dibya Choudhuri | Counselor | 135 Porter West Circle Drive, Ypsilanti, MI 48197 | 2019-12-05 |
| 1770128837 | Brian Lee Shue | Registered Nurse | 6277 Maplehurst Dr, Ypsilanti, MI 48197 | 2019-11-13 |
| 1639721566 | Darlene E Bellers | 845 W. Circle Dr, Suite 160, Ypsilanti, MI 48197 | 2019-07-11 | |
| 1073165874 | Eastern Michigan University | Dietitian, Registered | Suite 160 Rackham, Ypsilanti, MI 48197 | 2019-07-11 |
| 1447815469 | Rainbow Rehabilitation Centers, Inc. | Community Based Residential Treatment Facility, Mental Illness | 6200 Textile Rd, Ypsilanti, MI 48197 | 2019-05-06 |
| 1417416298 | Justin Brewer | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Drive Suite 2115, Ypsilanti, MI 48197 | 2019-03-19 |
| 1124519780 | Great Lakes Mindfulness LLC | Community/Behavioral Health | 4007 Carpenter Rd # 280, Ypsilanti, MI 48197 | 2018-05-19 |
| 1841799715 | Bedside Angel's Home Care, LLC | Home Health | 2032 S. Congress Street, Ypsilanti, MI 48197 | 2018-02-06 |
| 1891211777 | Brandon James Kukal | Specialist/Technologist | 799 N Hewitt, Ypslinati, MI 48197 | 2017-08-22 |
| 1669908737 | Michael Bekkerman | Student in an Organized Health Care Education/Training Program | 5303 Elliot Drive, Cancer Center, Ypsilanti, MI 48197 | 2017-05-10 |
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| 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 |
|---|---|---|---|---|
| 1548319411 | Anthony James Buto | Podiatrist | 2520 Packard Rd, Ypsilanti, MI 48197-1929 | 2007-01-09 |
| 1871676817 | Craig Ricardo Shelton | Podiatrist | 103 Dr John C Shelton Blvd, Ypsilanti, MI 48197-5412 | 2006-10-23 |
| 1740267731 | Lawrence David Tyner | Podiatrist | 101 S Adams St, Ypsilanti, MI 48197-5489 | 2005-12-29 |
| 1093702805 | Gretchen L Heutsche | Podiatrist | 5333 Mcauley Dr Rm 4012, Ypsilanti, MI 48197-1099 | 2005-10-05 |
| 1588141402 | Iha Health Services Corporation | Podiatrist | 5333 Mcauley Dr Rm 4012, Ypsilanti, MI 48197 | 2018-07-24 |
| 1588112619 | Ronald P. Adelman Dpm Pllc | Podiatrist | 3145 W Clark Rd, #201, Ypsilanti, MI 48197-1120 | 2016-09-19 |
| 1306015698 | Anthony J Buto, Dpm | Podiatrist | 2520 Packard Rd, Ypsilanti, MI 48197-1929 | 2008-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679185227 | Richard S Klimecki Dpm | Podiatrist | 30205 Schoenherr Rd Ste A, Warren, MI 48088-6800 | 2020-08-17 |
| 1063037075 | Vikrant Wadehra | Podiatrist | 27629 Chatsworth St, Farmington Hills, MI 48334-1821 | 2020-06-15 |
| 1255963401 | Metrocare Visiting Physicians Pllc | Podiatrist | 5700 Crooks Rd Ste 108, Troy, MI 48098-2818 | 2020-02-06 |
| 1053887869 | Canton Podiatry Pllc | Podiatrist | 42017 Ford Rd, Canton, MI 48187-3669 | 2018-10-18 |
| 1760961577 | Premier Foot & Ankle II Pllc | Podiatrist | 5777 W Maple Rd Ste 170, West Bloomfield, MI 48322-4448 | 2018-08-13 |
| 1609379395 | Nomad Podiatry Pllc | Podiatrist | 28230 S Pointe Ln, New Baltimore, MI 48051-2347 | 2018-03-09 |
| 1861993685 | Steven J. Repitor | Podiatrist | 8244 Metro Pkwy # C, Sterling Heights, MI 48312-2778 | 2018-02-27 |
| 1588179584 | Sheryl Bentzley Dpm PC | Podiatrist | 967 Brooklawn Dr, Troy, MI 48084-2659 | 2017-12-12 |
| 1598287914 | Fadee Ramzi Kakos | Podiatrist | 15830 Fort St Ste 8, Southgate, MI 48195-1348 | 2017-07-07 |
| 1104347178 | Benjamin Hartger | Podiatrist | 600 Park Ave Ste 3, Grand Haven, MI 49417-2173 | 2017-06-29 |
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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.