SPECIAL CARE PODIATRY OF MISSOURI, LLC (NPI# 1972922060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972922060 |
| Entity Type | Organization |
| Organization Name | SPECIAL CARE PODIATRY OF MISSOURI, LLC |
| Practice Address |
3714 Kidron St Jackson MO 63755-3345 |
| Mailing Address |
12910 Shelbyville Rd Suite 300 Louisville KY 40243-1593 |
| Practice Telephone | 5022442441 |
| Practice Fax Number | 5022544086 |
| Mailing Telephone | 5022442441 |
| Mailing Fax Number | 5022544086 |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2014-08-18 |
| Authorized Official Name | LEAH FRANCIS (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 5022442441 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers |
| Street Address |
3714 KIDRON ST |
| City | JACKSON |
| State | MO |
| Zip Code | 63755-3345 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942847413 | Southeast Hospital | Pharmacy | 2600 E. Main Street, Suite 113, Jackson, MO 63755 | 2019-12-04 |
| 1215438585 | The Villas of Jackson LLC | Assisted Living Facility | 670 Broadridge, Jackson, MO 63755 | 2018-02-22 |
| 1346637865 | Vitality Clinic | Health Educator | 111 N. Missouri Street, Jackson, MO 63755 | 2015-04-22 |
| 1144569567 | Rock Care In Home Services, LLC | Nursing Care | 204 S Union Ave, Jackson, MO 63755 | 2013-02-05 |
| 1447506381 | Morgan Allyce Strand | Optometrist | 2954 E. Jackson Blvd, Jackson, MO 63755 | 2012-07-30 |
| 1154689321 | Benjamin Gail Goodier | Dentist | 3100 East Jackson Blvd., Jackson, MO 63755 | 2012-04-25 |
| 1912278987 | Guardian Angels Homecare, LLC | Nursing Care | 1335 Old Cape Rd., Suite F, Jackson, MO 63755 | 2012-01-23 |
| 1528357829 | Sydney Nicole Cheek | Technician, Other | 107 Cottonwood St., Jackson, MO 63755 | 2011-04-07 |
| 1215162920 | Troy L Bell Od & Associates, PC | Optometrist | 2594 E Jackson Blvd, Jackson, MO 63755 | 2009-05-26 |
| 1932398021 | Immediate Healthcare, Inc. | General Practice | 1508 Edgemont Blvd, Perryville, MO 63755 | 2007-10-15 |
| Find all providers in zip 63755 | ||||
| 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 |
|---|---|---|---|---|
| 1124344478 | Darryl J Martins | Podiatrist | 100 S Cooper St, Jackson, MI 49201-1598 | 2010-04-12 |
| 1174742530 | Mobile Physicians LLC | Podiatrist | 7 Colts Ct, Jackson, NJ 08527-4492 | 2007-04-24 |
| 1033286307 | Lowery H Huff | Podiatrist | 500 0 Woodrow Wilson Ave, Jackson, MS 39216 | 2006-11-29 |
| 1164592044 | Bryan Tipton Sullivan | Podiatrist | 1915 Dunbarton Drive, Jackson, MS 39216 | 2006-11-08 |
| 1649364860 | Farzad Faryabi | Podiatrist | 2475 Lakeland Drive, Suite B, Jackson, MS 39232 | 2006-10-03 |
| 1700977378 | Family Foot Care Center | Podiatrist | 2033 Greystone Office Park, Jackson, TN 38305 | 2006-09-27 |
| 1700989118 | David Lee Dutra | Podiatrist | 613 New York Ranch Rd, Jackson, CA 95642-9328 | 2006-09-07 |
| 1851339899 | Center for Diabetes Foot Care | Podiatrist | 820 Cooper Rd, Suite I, Jackson, MS 39212-4099 | 2006-06-03 |
| 1689636169 | Jackson Foot and Ankle Clinic | Podiatrist | 345 E Main St, Suite C, Jackson, OH 45640-1779 | 2006-04-03 |
| 1952370132 | Keith Brian Rosenthal | Podiatrist | 180 N County Line Rd, Ste H, Jackson, NJ 08527-4421 | 2006-03-17 |
| Find all providers in JACKSON | ||||
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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.