GWINNETT PODIATRY ASSOCIATES LLC (NPI# 1134267636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134267636 |
| Entity Type | Organization |
| Organization Name | GWINNETT PODIATRY ASSOCIATES LLC |
| Practice Address |
545 Old Norcross Rd Suite 300 Lawrenceville GA 30045-3389 |
| Practice Telephone | 7709636300 |
| Practice Fax Number | 7706820578 |
| Mailing Telephone | 7709636300 |
| Mailing Fax Number | 7706820578 |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. RICHARD P MISTRETTA (MANAGING PARTNER) |
| Authorized Official Telephone | 7702329778 |
| 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 |
00742 | GA | Podiatric Medicine & Surgery Service Providers |
| Street Address |
545 OLD NORCROSS RD SUITE 300 |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30045-3389 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104818764 | Ivory Myrick Bryant | Speech-Language Pathologist | 545 Old Norcross Rd, Suite 100, Lawrenceville, GA 30046-3389 | 2005-08-19 |
| 1134772502 | Alexandra Juliet Bass | Speech-Language Pathologist | 545 Old Norcross Rd, Lawrenceville, GA 30046-3389 | 2019-07-24 |
| 1689133985 | Nichole Hammer | Speech-Language Pathologist | 545 Old Norcross Rd, Lawrenceville, GA 30046-3389 | 2019-03-16 |
| 1861906075 | Jessica Okpara | Nurse Practitioner | 545 Old Norcross Rd, Lawrenceville, GA 30046-3389 | 2017-11-27 |
| 1568903722 | Adaky Chidundo Taylor | Physician Assistant | 545 Old Norcross Rd, #300, Lawrenceville, GA 30046-3389 | 2017-03-20 |
| 1538617543 | Nmamah K Sinlah | Speech-Language Pathologist | 545 Old Norcross Rd, Suite 100, Lawrenceville, GA 30046-3389 | 2016-09-19 |
| 1124574025 | Sarah Elisabeth Jones | Speech-Language Pathologist | 545 Old Norcross Rd, Suite 200, Lawrenceville, GA 30046-3389 | 2016-08-30 |
| 1528418654 | Pamela Willis | Speech-Language Pathologist | 545 Old Norcross Rd, Suite 100, Lawrenceville, GA 30046-3389 | 2016-06-20 |
| 1578912853 | Matthew William Nagle | Physical Therapist | 545 Old Norcross Rd, Suite 100, Lawrenceville, GA 30046-3389 | 2016-06-08 |
| 1417304114 | Henley Slepyan | Speech-Language Pathologist | 545 Old Norcross Rd, Suite 100, Lawrenceville, GA 30046-3389 | 2016-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285104315 | Shalanda Monique Booker | Counselor | 2940 Emerald Springs Drive, Lawrenceville, GA 30045 | 2018-12-02 |
| 1669957320 | Chantelle S Fuller | Behavioral Analyst | 805 Donington Cir, Lawrenceville, GA 30045 | 2018-09-28 |
| 1356836035 | Gad Health Care LLC | Home Health | 1140 Great Oaks Dr, Lawrenceville, GA 30045 | 2018-06-26 |
| 1346668662 | Eca Optical, LLC | Eyewear Supplier (Equipment, not the service) | 601-a Professional Drive, Ste 170, Lawrenceville, GA 30045 | 2014-04-03 |
| 1598102733 | Selena Fuller | Nurse Practitioner | 181 South Clayton Street, Lawrenceville, GA 30045 | 2013-05-29 |
| 1942555982 | Vida Michele James-bryant | Community Health Worker | 1309 Avington Glen Dr, Lawrenceville, GA 30045 | 2012-07-16 |
| 1770840639 | Rebecca Vinson D'angelo | Occupational Therapist | 1518 Great Shoals Cir, Lawrenceville, GA 30045 | 2012-04-17 |
| 1427346774 | Amanda Michelel Woods | Psychologist | 285 South Perry Street, Lawrenceville, GA 30045 | 2011-07-20 |
| 1790070563 | M & G Pharmacy Inc | Pharmacy | 100 Hurricane Shoals Rd Suite F, Lawrenceville, GA 30045 | 2011-06-09 |
| 1306146154 | Thanh Dau | Optometrist | 1250 Scenic Highway, Ste 1268, Lawrenceville, GA 30045 | 2010-10-27 |
| Find all providers in zip 30045 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659905685 | New Jersey Podiatric Physicians & Surgeons Group LLC | Podiatrist | 132 Franklin Corner Rd Ste C1, Lawrenceville, NJ 08648-2523 | 2020-02-28 |
| 1194245894 | Yusuf Abiodun Opakunle | Podiatrist | 600 Professional Dr Ste 130, Lawrenceville, GA 30046-7638 | 2017-06-23 |
| 1356779540 | Michael Banh | Podiatrist | 132 Franklin Corner Rd Ste C-1, Lawrenceville, NJ 08648-2523 | 2013-10-24 |
| 1699030163 | Mi Kyung Kim | Podiatrist | 1790 Atkinson Rd Ste D200, Lawrenceville, GA 30043-7991 | 2012-07-10 |
| 1275521270 | James L Bouchard | Podiatrist | 15 Hurricane Shoals Rd Ne, Suite A, Lawrenceville, GA 30046-4454 | 2005-10-12 |
| 1235747031 | Lawrenceville Foot and Ankle Specialists | Podiatrist | 600 Professional Dr Ste 130, Lawrenceville, GA 30046-7638 | 2020-07-17 |
| 1023461811 | Mk Podiatry LLC | Podiatrist | 1790 Atkinson Rd Ste D200, Lawrenceville, GA 30043-7991 | 2016-07-18 |
| 1821263963 | Allied Ankle & Footcare Centers PC | Podiatrist | 15 Hurricane Shoals Rd Ne, Suite B, Lawrenceville, GA 30046-4454 | 2008-04-29 |
| 1861528689 | Allied Ankle & Foot Care Centers PC | Podiatrist | 15 Hurricane Shoals Rd Ne, Lawrenceville, GA 30046-4454 | 2007-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518515980 | Da Vinci Foot and Ankle Madison LLC | Podiatrist | 1740 Lions Club Rd Ste 200, Madison, GA 30650-4762 | 2019-08-29 |
| 1376191106 | Ryan Goldfine Dpm LLC | Podiatrist | 3451 Ernest W Barrett Pkwy Suite 170, Mariettta, GA 30269 | 2019-08-26 |
| 1073076170 | Kalish Foot & Ankle Institute | Podiatrist | 6911 Tara Blvd Ste 101, Jonesboro, GA 30236-1503 | 2019-04-08 |
| 1427523919 | Tommy Lee Tally | Podiatrist | 8225 Mall Pkwy Ste 230, Lithonia, GA 30038-6913 | 2018-10-10 |
| 1881188944 | Joshua Jae Lee | Podiatrist | 3425 Buford Dr Ste 350, Buford, GA 30519-8785 | 2018-06-21 |
| 1437652815 | Southeast Regional Primary Care Corporation | Podiatrist | 1707 Meadows Ln Ste H, Vidalia, GA 30474-7201 | 2018-03-13 |
| 1447762927 | Ponders Podiatry LLC | Podiatrist | 275 Carpenter Drive Ne, Suite 106, Atlanta, GA 30328 | 2017-10-24 |
| 1891228540 | Vishal Patel | Podiatrist | 755 Mount Vernon Hwy Ne Ste 210, Atlanta, GA 30328-4279 | 2017-04-10 |
| 1497296552 | Ankle and Foot Assoc, LLC | Podiatrist | 118 Azalea Rd, Suite 1-2, Baxley, GA 31513-0672 | 2017-03-09 |
| 1245770437 | Ankle and Foot Assoc, LLC | Podiatrist | 94 Andrews Way, Saint Marys, GA 31558-1632 | 2017-03-07 |
| Find all providers with the same taxonomy | ||||
| City | LAWRENCEVILLE |
| Zip Code | 30045 |
Please comment or provide details below to improve the information on GWINNETT PODIATRY ASSOCIATES LLC.
| 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.