DR. LAUREL A TAIT (NPI# 1831119676) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831119676 |
| Entity Type | Individual |
| Full Name | DR. LAUREL A TAIT |
| Credential | DPM |
| Practice Address |
604 S Main St Water Valley MS 38965-3468 |
| Mailing Address |
3880 Majestic Oaks Dr Oxford MS 38655-8143 |
| Practice Telephone | 6622367070 |
| Practice Fax Number | 6622367078 |
| Mailing Telephone | 6622367070 |
| Mailing Fax Number | 6622367078 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2011-09-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
MO00556 | MO | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 02358739 | 05 | |
| MO | RAILROAD MEDICARE | 480005007 | 01 |
| MO | BLUE CROSS BLUE SHIELD | 12934038 | 01 |
| Street Address |
604 S MAIN ST |
| City | WATER VALLEY |
| State | MS |
| Zip Code | 38965-3468 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548828882 | Deana Terry | Nurse Practitioner | 604 S Main St, Water Valley, MS 38965-3468 | 2019-06-02 |
| 1023528155 | Dominika Alina Jegen | Family Medicine | 604 S Main St, Water Valley, MS 38965-3468 | 2017-10-03 |
| 1669826111 | Antoinette Taylor | Family Medicine | 604 S Main St, Water Valley, MS 38965 | 2016-04-21 |
| 1033581665 | Demetrica Stokes Pegues | Nurse Practitioner | 604 S Main St, Water Valley, MS 38965-3468 | 2015-10-22 |
| 1487040663 | Alice Lee | Dietitian, Registered | 604 S Main St, Water Valley, MS 38965-3468 | 2015-04-14 |
| 1285033571 | Joeli Link | Nurse Practitioner | 604 S Main St, Water Valley, MS 38965-3468 | 2014-08-22 |
| 1972910321 | Jessica Richardson | Nurse Practitioner | 604 S Main St, Water Valley, MS 38965-3468 | 2014-07-17 |
| 1972865871 | Stacy Parker Thomas | Nurse Practitioner | 604 S Main St, Water Valley, MS 38965-3468 | 2012-06-15 |
| 1114980042 | Heidi D Pratt | Family Medicine | 604 S Main St, Water Valley, MS 38965-3468 | 2006-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083087985 | Family Health Care Clinic, Inc. | Clinic/Center | 102 Blackmur Dr, Water Valley, MS 38965 | 2015-11-02 |
| 1770713893 | Ben F Toole | Counselor | 1285 County Road 151, Water Valley, MS 38965 | 2009-07-23 |
| 1053451880 | North Mississippi Foot Specialists PC | Durable Medical Equipment & Medical Supplies | 630 South Main St, Water Valley, MS 38965 | 2007-02-08 |
| 1003977281 | Barney Lee Pullen Jr. | Dentist | 117 Wood St, Water Valley, MS 38965 | 2006-12-12 |
| 1912070277 | Water Valley Rural Health Paul Odom Md | Clinic/Center | 645 South Main Street, Water Valley, MS 38965 | 2006-11-16 |
| 1255414173 | Family Practice Clinic of Water Valley | Family Medicine | 606 So Main St, Water Valley, MS 38965 | 2006-10-23 |
| 1073609467 | Paul Leroy Odom | Family Medicine | 604 South Main Street, Water Valley, MS 38965 | 2006-10-05 |
| 1730129164 | Quality Medical Service, Inc | Durable Medical Equipment & Medical Supplies | Quality Medical Services, Inc, 48 S Main Street, Water Valley, MS 38965 | 2006-06-07 |
| 1124687207 | Dontavious Toles | Physical Therapy Assistant | 50 Main St, Water Valley, MS 38965 | 2019-06-11 |
| 1659607232 | Cinnamon Caryl Foster | Nurse Practitioner | 712 S Main St, Water Valley, MS 38965 | 2009-11-02 |
| Find all providers in zip 38965 | ||||
| Taxonomy Code | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336594985 | Nkechinyere Christina Nwoko | Podiatrist | 46 Sgt Prentiss Dr Ste 201b, Natchez, MS 39120 | 2016-05-02 |
| 1770942146 | Sarah Lynn Freed | Podiatrist | 9065 Sandidge Center Cv Ste C, Olive Branch, MS 38654-3574 | 2016-02-15 |
| 1609996982 | Larry K Cruel | Podiatrist | 4510 Office Park Dr, Jackson, MS 39206-6016 | 2007-03-30 |
| 1740309590 | Madison Foot Clinic, Pllc | Podiatrist | 980 Highway 51 Ste B, Madison, MS 39110-8409 | 2007-03-29 |
| 1386715514 | Bruce K. Boyd | Podiatrist | 211 Alcorn Dr, Corinth, MS 38834-8400 | 2006-11-10 |
| 1144316092 | Foot Clinic of Hattiesburg, P.a. | Podiatrist | 710 S 28th Ave, Ste B, Hattiesburg, MS 39402-2585 | 2006-10-05 |
| 1376561779 | Ricky Roach | Podiatrist | 999 N Halstead Rd, Ocean Springs, MS 39564-3105 | 2006-07-17 |
| 1972537041 | Willie James Lewis Sr. | Podiatrist | 128 Poindexter St, Jackson, MS 39203-3048 | 2006-07-11 |
| 1790779858 | Rose Marie Sotolongo | Podiatrist | 731 S Pear Orchard Rd, Suite 7, Ridgeland, MS 39157-4800 | 2005-09-06 |
| 1598037798 | Oh for Feet Sake, LLC. | Podiatrist | 368 Scarbrough St, Suite B, Richland, MS 39218-9038 | 2012-02-02 |
| Find all providers with the same taxonomy | ||||
| City | WATER VALLEY |
| Zip Code | 38965 |
Please comment or provide details below to improve the information on DR. LAUREL A TAIT.
| 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.