JOHN RANDALL NORTHRUP (NPI# 1891178406) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891178406 |
| Entity Type | Individual |
| Full Name | JOHN RANDALL NORTHRUP |
| Credential | D.P.M. |
| Practice Address |
1690 Us Highway 1 S Ste C St Augustine FL 32084-6024 |
| Practice Telephone | 9044368001 |
| Practice Fax Number | 9043776776 |
| Mailing Telephone | 9044368001 |
| Mailing Fax Number | 9043776776 |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2020-04-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213E00000X | Podiatrist | PO3952 | FL | Podiatric Medicine & Surgery Service Providers |
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
PO3952 | FL | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 101521600 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 145 Cypress Point Pkwy Ste 105, Palm Coast, FL 321648427 | 9044368001 | |
| 9 Pine Cone Dr Ste 101, Palm Coast, FL 321378683 | 9044368001 | 9043767761 |
| Street Address |
1690 US HIGHWAY 1 S STE C |
| City | ST AUGUSTINE |
| State | FL |
| Zip Code | 32084-6024 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295347599 | Cody Martyn | Pharmacist | 955 Fl-16, St. Augustine, FL 32084 | 2020-08-18 |
| 1912562471 | Kjcares Suportive Living Services | Case Manager/Care Coordinator | 20 First Street, Apt 5, St. Augustine, FL 32084 | 2019-05-09 |
| 1558841684 | Kevin D Roberts | Psychologist | 20 First Street Apt 5, St. Augustine, FL 32084 | 2018-08-17 |
| 1568954576 | Gwendolyn Marie Spong | Nurse Practitioner | 2703 N Ponce De Leon Blvd., Minute Clinic #3591, Area 4, Region 46, St. Augustine, FL 32084 | 2018-06-05 |
| 1770940116 | Marian L. Turner-sharpton, Lcsw | Social Worker | 17 Pacific St., Suite 2 (growth Pointe), St. Augustine, FL 32084 | 2016-01-15 |
| 1710358932 | Florida Laboratory Analysis, LLC | Clinical Medical Laboratory | 1690 Us Highway 1 S Ste D, St Augustine, FL 32084 | 2015-10-14 |
| 1780064774 | J Mae Transportation | Non-emergency Medical Transport (VAN) | 28 N Whitney St Apt 404, St Augustine, FL 32084 | 2015-06-04 |
| 1497154520 | Suzanne Smith Weed | Nurse Practitioner | 32 Mulberry Street, Saint Augustine, FL 32084 | 2014-08-14 |
| 1447684469 | Rachel Moran | Counselor | 162 Oneida Street, St. Augustine, FL 32084 | 2013-08-27 |
| 1932545993 | Matrix Medical, LLC | Durable Medical Equipment & Medical Supplies | 56 S Dixie Hwy Ste 1, St Augustine, FL 32084 | 2013-05-17 |
| Find all providers in zip 32084 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659587897 | Thomas Anthony Lebeau | Podiatrist | 1 Saint Johns Medical Park Dr, St Augustine, FL 32086-5300 | 2007-05-15 |
| 1578576179 | Rosana Rodriguez | Podiatrist | 6 Saint Johns Medical Park Dr, St Augustine, FL 32086-4233 | 2006-08-14 |
| 1841237864 | John A Cunningham | Podiatrist | 3829 Paddington Pl, St Augustine, FL 32092-3660 | 2006-05-31 |
| 1972994770 | Emmanuel Lagoutaris, Dpm, LLC | Podiatrist | 300 Kingsley Lake Dr, Ste. 402, St Augustine, FL 32092-3037 | 2015-02-15 |
| 1376887661 | Hany M Jeffry | Podiatrist | 6 Saint Johns Medical Park Dr, St Augustine, FL 32086-5298 | 2012-11-27 |
| 1972834760 | Coastal Foot & Ankle Wellness Center LLC | Podiatrist | 200 Southpark Blvd, Suite 208, St Augustine, FL 32086-3129 | 2010-01-19 |
| 1649409756 | St. Augustine Foot & Ankle, Inc | Podiatrist | 1 Saint Johns Medical Park Dr, St Augustine, FL 32086-5300 | 2009-07-09 |
| 1730354523 | Community Podiatry & Wound Care Pa | Podiatrist | 6 Saint Johns Medical Park Dr, St Augustine, FL 32086-4233 | 2008-04-23 |
| 1033195979 | Ryan J Pereira | Podiatrist | 1301 Plantation Island Dr S, Ste 203, St Augustine, FL 32080-3108 | 2005-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693120 | Mozhgan Alijani, Dpm, Pa | Podiatrist | 20515 E Country Club Dr Apt 544, Miami, FL 33180-3442 | 2020-09-11 |
| 1730790551 | Sacred Heart Hospital of Pensacola | Podiatrist | 1890 Summit Blvd, Pensacola, FL 32503 | 2020-08-14 |
| 1306457841 | Asdj LLC | Podiatrist | 2190 Bridgeport Cir, Rockledge, FL 32955-4338 | 2020-08-10 |
| 1316557762 | Upperline Healthcare, PC | Podiatrist | 2111 Glenwood Dr Ste 104, Winter Park, FL 32792-3328 | 2020-07-31 |
| 1790395135 | Upperline Healthcare, PC | Podiatrist | 339 Cypress Pkwy Ste 240, Kissimmee, FL 34759-3315 | 2020-07-31 |
| 1952911398 | Upperline Healthcare, PC | Podiatrist | 250 N Alafaya Trl Ste 115, Orlando, FL 32828-4336 | 2020-07-31 |
| 1639789076 | Upperline Healthcare, PC | Podiatrist | 650 S Courtenay Pkwy Ste 200, Merritt Island, FL 32952-4977 | 2020-07-31 |
| 1972113314 | Upperline Healthcare, PC | Podiatrist | 8000 Red Bug Lake Rd Ste 230, Oviedo, FL 32765-9265 | 2020-07-31 |
| 1356950646 | Palm Beach Foot & Ankle Inc | Podiatrist | 8130 Royal Palm Blvd Ste 205, Coral Springs, FL 33065-5703 | 2020-07-23 |
| 1720601891 | Yohandy Fuentes Dpm Pa | Podiatrist | 5200 Sw 8th St Ste 201a, Coral Gables, FL 33134-2337 | 2020-05-24 |
| Find all providers with the same taxonomy | ||||
| City | ST AUGUSTINE |
| Zip Code | 32084 |
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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.