AVON LAKE PODIATRY INC (NPI# 1992864490) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992864490 |
| Entity Type | Organization |
| Organization Name | AVON LAKE PODIATRY INC |
| Practice Address |
32730 Walker Rd Suite I-3 Avon Lake OH 44012-4100 |
| Practice Telephone | 4409334021 |
| Practice Fax Number | 4409337132 |
| Mailing Telephone | 4409334021 |
| Mailing Fax Number | 4409337132 |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2008-05-29 |
| Authorized Official Name | DR. MARK DAVID GOULD (PRESIDENT) |
| Authorized Official Telephone | 4409334021 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
36.002416 | OH | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | RAILROAD MEDICARE | 480004004 | 01 |
| Street Address |
32730 WALKER RD SUITE I-3 |
| City | AVON LAKE |
| State | OH |
| Zip Code | 44012-4100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699767715 | Rayeka Sitabkhan | Pediatrics | 32730 Walker Rd, Building H, Avon Lake, OH 44012-4100 | 2005-08-16 |
| 1568896124 | Paula Jacobson | Social Worker | 32730 Walker Rd, Avon Lake, OH 44012-4100 | 2013-08-30 |
| 1689940884 | Michael Holland | Massage Therapist | 32730 Walker Rd, Suite 1 Building 1, Avon Lake, OH 44012-4100 | 2012-04-02 |
| 1326357427 | Chiropractic Concepts of Avon Lake Inc | Chiropractor | 32730 Walker Rd, F3, Avon Lake, OH 44012-4100 | 2010-10-07 |
| 1790952000 | Landings Family & Psychological Center, Inc. | Social Worker | 32730 Walker Rd, Suite I-5, Avon Lake, OH 44012-4100 | 2008-05-15 |
| 1891975652 | Christina Marie Trillis | Internal Medicine | 32730 Walker Rd, Bldg H, Avon Lake, OH 44012-4100 | 2007-11-09 |
| 1568641462 | Aesthetics Within, Inc | Plastic Surgery | 32730 Walker Rd, Suite F1, Avon Lake, OH 44012-4100 | 2007-10-26 |
| 1275725715 | Mary O'malley | Social Worker | 32730 Walker Rd, Avon Lake, OH 44012-4100 | 2007-08-17 |
| 1730245127 | Geoffrey Albert Poyle | Chiropractor | 32730 Walker Rd, Suite F3, Avon Lake, OH 44012-4100 | 2006-12-29 |
| 1013026061 | Respiratory Solutions Inc. | Durable Medical Equipment & Medical Supplies | 32730 Walker Rd, D-1, Avon Lake, OH 44012-4100 | 2006-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649743352 | Wyatt Demarco Massage Therapy & Wellness Center | Massage Therapist | 690 Avon Belden Rd, 2c, Avon Lake, OH 44012 | 2019-01-04 |
| 1659789915 | Self | Home Health | 33803 Electric Blvd, E4, Avonlake, OH 44012 | 2014-07-30 |
| 1427489566 | Thomas Gerosky, D.m.d. Inc | Dentist | 215 Miller Road, Avon Lake, OH 44012 | 2013-11-27 |
| 1558619676 | Lindsay Stein | Counselor | 156a Lear Rd, Avon Lake, OH 44012 | 2012-08-21 |
| 1023388063 | Jennifer Lynn Dorman | Dietitian, Registered | 167 Belmar Boulevard, Avon Lake, OH 44012 | 2012-01-09 |
| 1033495338 | Jessica Rae Wyatt | Massage Therapist | 690 Avon Belden Rd Ste 2c, Avon Lake, OH 44012 | 2011-10-31 |
| 1841599248 | Robin M Hale | Counselor | 32831 Redwood Blvd, Avon Lake, OH 44012 | 2011-03-24 |
| 1265551766 | Robert Day Monroe | Podiatrist | 32118 Augusta Dr, Avon Lake, OH 44012 | 2007-03-28 |
| 1194822908 | John Secrest Pyke IIi | Dentist | 33399 Walker Rd, Suite D, Avon Lake, OH 44012 | 2006-09-20 |
| 1295842284 | Westshore Primary Care Assoc Inc | Internal Medicine | 32730 Walker Road, Building H, Avon Lake, OH 44012 | 2006-08-24 |
| Find all providers in zip 44012 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740257302 | Mark David Gould | Podiatrist | 32730 Walker Rd, Suite I-3, Avon Lake, OH 44012-4100 | 2006-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992321228 | Mary Matta | Podiatrist | 425 West Fith Street, East Liverpool, OH 43920 | 2020-06-23 |
| 1063047942 | Jennifer C. Swan, Dpm, LLC | Podiatrist | 155 Commerce Park Dr Ste 7, Westerville, OH 43082-8384 | 2020-03-11 |
| 1518599117 | Howard Waxman | Podiatrist | 35000 Chardon Rd Ste 220, Willoughby Hills, OH 44094-9019 | 2020-02-11 |
| 1346887510 | Performance Foot and Ankle, LLC | Podiatrist | 3727 Friendsville Rd Unit 2, Wooster, OH 44691-7127 | 2019-12-05 |
| 1053971200 | Lauren Digregorio Dpm | Podiatrist | 1502 Lear Industrial Pkwy Ste 1a, Avon, OH 44011-1380 | 2019-06-19 |
| 1477117331 | North Eastern Ohio Podiatry Group LLC | Podiatrist | 4200 Warrensville Center Road, Suite 271, Warrensville Heights, OH 44122-6805 | 2019-04-26 |
| 1336611672 | Anthony G Polito Dpm Inc | Podiatrist | 4071 N Jefferson St, Medina, OH 44256-5622 | 2018-12-27 |
| 1023547957 | Phuoc Bui | Podiatrist | 4260 Glendale Mildford Rd. Ste 103, Blue Ash, OH 45242 | 2017-06-05 |
| 1639606619 | David Mathew Bishop | Podiatrist | 200 East State St, Alliance Community Hospital, Alliance, OH 44601 | 2017-05-22 |
| 1174058630 | Lance Jon Johnson | Podiatrist | 1400 W Main St Bldg 1, Suite A, Bellevue, OH 44811-9429 | 2017-04-21 |
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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.