DR. CHARLES WILLIAM CONNOLLY (NPI# 1932105095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1932105095 |
Entity Type | Individual |
Full Name | DR. CHARLES WILLIAM CONNOLLY |
Credential | DPM |
Practice Address |
120 College Ave Somerville MA 02144-1919 |
Practice Telephone | 6177762500 |
Practice Fax Number | 6177763850 |
Mailing Telephone | 7815931700 |
Enumeration Date | 2005-06-23 |
Last Update Date | 2012-04-24 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 213E00000X | Podiatrist | 1784 | MA | Podiatric Medicine & Surgery Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MA | 0361968 | 05 | |
MA | UNITED HEALTHCARE | 2700037 | 01 |
MA | HARVARD PILGRIM HEALTH CA | 33386 | 01 |
MA | BLUE SHIELD OF MA | Y70860 | 01 |
MA | TUFTS HEALTH PLAN | 709158 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174779391 | Charles John Connolly Jr. | Chiropractor | 15 Millet St, Dix Hills, NY 11746 | 2008-08-08 |
1992937759 | Charles Mathew Connolly | Physical Therapy Assistant | 9160 W 64th Ave, Arvada, CO 80004-3111 | 2009-08-12 |
Street Address |
120 COLLEGE AVE |
City | SOMERVILLE |
State | MA |
Zip Code | 02144-1919 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386106953 | Star Markets Company Inc | Durable Medical Equipment & Medical Supplies | 90 Causeway St, Boston, MA 02144 | 2019-04-03 |
1841769460 | Jeffrey Shwom | Technician/Technologist | 40 Holland Street, 1st Floor, Somerville, MA 02144 | 2018-11-14 |
1689106700 | Michelle Dyrholm | Anesthesiology | Massachusetts General Hospital, Dept of Anesthesia, 55 Fruit Street, Gray-bigelow 444, Boston, MA 02144 | 2017-03-29 |
1275089575 | Nancy Landry Pllc | Family Medicine | Somerville Family Practice, 1020 Broadway, Somerville, MA 02144 | 2016-08-28 |
1982019451 | Wilson Garcia Acosta | Specialist | 278 Powderhouse, Somerville, MA 02144 | 2014-06-24 |
1376954289 | Jonathan Farr | Counselor | 1236 Broadway Ste 12, Somerville, MA 02144 | 2014-05-13 |
1356751945 | Christina Sakelarakis | Psychologist | 73 Fairfax St, Somerville, MA 02144 | 2014-05-05 |
1578905816 | Nicolle Woods | Behavioral Analyst | 58 Day St #441938, Somerville, MA 02144 | 2013-07-29 |
1306130018 | Emily Elizabeth Wheeler | Psychologist | 259 Elm St Ste 201, Somerville, MA 02144 | 2011-05-31 |
1932363355 | Hang Le Ngo | Psychologist | 53 Chester Street, Somerville, MA 02144 | 2008-07-15 |
Find all providers in zip 02144 |
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 |
---|---|---|---|---|
1871525253 | John Elijah Bell | Podiatrist | 305 Lake Dr, Somerville, TN 38068-9724 | 2006-07-07 |
1801383088 | Candria Consulting and Holdings Inc | Podiatrist | 53 Main St, Somerville, MA 02145-1448 | 2018-04-13 |
1184860835 | Pasquale Cancelliere | Podiatrist | 53 Main St, Somerville, MA 02145-1448 | 2008-12-31 |
1760430755 | Michael Hercules Theodoulou | Podiatrist | 230 Highland Ave, Somerville, MA 02143-1408 | 2006-05-04 |
1588628853 | Brian D Tedesco | Podiatrist | 53 Main St, Somerville, MA 02145-1448 | 2006-04-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770052623 | Edward Joseph Salem | Podiatrist | 18 Hadley Village Rd Apt D, South Hadley, MA 01075-2272 | 2018-11-21 |
1497230171 | Coastal Foot & Ankle Inc | Podiatrist | 300 Hanover St Ste 2c, Fall River, MA 02720-5451 | 2018-09-28 |
1942794656 | Christopher H. Peteros, Dpm, LLC | Podiatrist | 1200 Converse St Ste 103, Longmeadow, MA 01106-1760 | 2018-06-16 |
1003309444 | Plymouth Podiatry PC | Podiatrist | 135 Sandwich St Ste 1, Plymouth, MA 02360-2400 | 2018-06-11 |
1972024735 | Richa Piyush Patel | Podiatrist | 100 Crossing Blvd Ste 300, Framingham, MA 01702-5555 | 2017-07-03 |
1508391186 | Steven Quan | Podiatrist | 70 Wesson Ave, Quincy, MA 02169-7412 | 2017-04-20 |
1598117350 | Melissa Lynn Ricci | Podiatrist | 100 Highland St Ste 122, Milton, MA 02186-3878 | 2016-07-05 |
1639528987 | Sturdy Memorial Associates, Inc | Podiatrist | 7 Wilkins Drive, Plainville, MA 02762 | 2016-06-08 |
1043669591 | Sara Elizabeth Rose-sauld | Podiatrist | 52 2nd Ave Ste 1150, Waltham, MA 02451-1129 | 2016-06-06 |
1558743880 | Alissa Kuizinas | Podiatrist | 54 Baker Avenue Ext Ste 301, Concord, MA 01742-2139 | 2015-06-23 |
Find all providers with the same taxonomy |
City | SOMERVILLE |
Zip Code | 02144 |
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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.