BRYAN V FALLIS (NPI# 1083606974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083606974 |
| Entity Type | Individual |
| Full Name | BRYAN V FALLIS |
| Credential | D.P.M. |
| Practice Address |
2300 Chambers Center Dr Suite 100 Fort Mitchell KY 41017 |
| Mailing Address |
Po Box 636389 Cincinnati OH 45263-0001 |
| Practice Telephone | 8593312440 |
| Practice Fax Number | 8593312449 |
| Mailing Telephone | 5139310083 |
| Mailing Fax Number | 8593312449 |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2020-01-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213E00000X | Podiatrist | 244160 | KY | Podiatric Medicine & Surgery Service Providers |
| Y | 213E00000X | Podiatrist | 36003149 | OH | Podiatric Medicine & Surgery Service Providers |
| N | 213E00000X | Podiatrist | 00258 | KY | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2955422 | 05 | |
| KY | 7100096290 | 05 | |
| KY | 80000151 | 05 | |
| OH | 2214213 | 05 | |
| KY | RAILROAD MEDICARE | P00732469 | 01 |
| OH | ANTHEM | 000000619072 | 01 |
| Street Address |
2300 CHAMBERS CENTER DR SUITE 100 |
| City | FORT MITCHELL |
| State | KY |
| Zip Code | 41017 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578187209 | St. Elizabeth Medical Center, Inc. | Pharmacy | 1 Medical Village Dr., Edgewood, KY 41017 | 2020-05-28 |
| 1366084337 | St. Elizabeth Medical Center, Inc. | Pharmacy | 850 Thomas More Parkway, Edgewood, KY 41017 | 2019-10-11 |
| 1396396750 | Family First Vision Care Kentucky | Optometrist | 614 Buttermilk Pike, Fort Mitchell, KY 41017 | 2019-09-26 |
| 1083184543 | Katie Franconia Smith | Nurse Practitioner | 2865 Chancellor Dr., Crestview Hills, KY 41017 | 2018-11-27 |
| 1871077511 | Janet Reeves Martin | Nurse Practitioner | Infinity Dialysis, 4750 East Galbraith Rd. Suite 103, Cincinnati, OH 41017 | 2018-09-19 |
| 1144713983 | Kelly Wiechart | Dentist | 599 Freedom Park Dr Ste 100, Crestview Hills, KY 41017 | 2018-06-06 |
| 1225535966 | Proscan Radiology Northern Kentucky, LLC | Radiology | 350 Thomas More Pkwy Ste 170, Crestview Hills, KY 41017 | 2018-04-10 |
| 1396241626 | Tressa S. Leahy | Physical Therapist | 200 Medical Village Drive, Edgewood, KY 41017 | 2018-04-04 |
| 1699294470 | Raymond Gardinier | Physical Therapist | 3755 Old Ky 17, Fort Wright, KY 41017 | 2017-09-13 |
| 1992229785 | Adrienne Bussard | Physician Assistant | 334 Thomas More Pkwy Ste 120, Crestview Hills, KY 41017 | 2017-08-02 |
| Find all providers in zip 41017 | ||||
| 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 |
|---|---|---|---|---|
| 1366079543 | King's Daughters Medical Specialties, Inc. | Podiatrist | 1000 Ashland Dr Ste 104, Ashland, KY 41101-7092 | 2020-03-26 |
| 1578112983 | Peter Cunningham | Podiatrist | 1 Audubon Plaza Dr Ofc L2, Louisville, KY 40217-1318 | 2019-09-09 |
| 1447787676 | Jenna Vaught LLC | Podiatrist | 3407 Kerry Dr, Louisville, KY 40218-2131 | 2017-05-18 |
| 1528429289 | Carrie A. Tull, Dpm LLC | Podiatrist | 272 Redwing Dr, Winchester, KY 40391-2928 | 2016-03-09 |
| 1083907471 | Larry K Ketcherside | Podiatrist | 9110 Leesgate Rd, Louisville, KY 40222-5053 | 2011-05-18 |
| 1013210251 | Dr. Robert F Hailey, Dpm Psc | Podiatrist | 333 S 6th St, Mayfield, KY 42066-2309 | 2010-12-09 |
| 1558516054 | Jessica S Jackson Dpm Pllc | Podiatrist | 15014 Bircham Rd, Louisville, KY 40245-4104 | 2008-11-25 |
| 1568625903 | Janine A. Valentino | Podiatrist | 9880 Angies Way Suite 110, Louisville, KY 40241-2943 | 2008-07-07 |
| 1518134386 | Jennifer Benge Emery | Podiatrist | 427 Us 31w Byp Ste 202, Bowling Green, KY 42101-1703 | 2008-05-12 |
| 1760676092 | Advanced Foot Care of Northern Ky | Podiatrist | 1880 Ashwood Cir, Ft Wright, KY 41011-2602 | 2007-08-29 |
| Find all providers with the same taxonomy | ||||
| City | FORT MITCHELL |
| Zip Code | 41017 |
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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.