GEORGE S TELLAM (NPI# 1154793339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154793339 |
| Entity Type | Organization |
| Organization Name | GEORGE S TELLAM |
| Other Organization Name | ANKLE & FOOT ASSOCIATES |
| Practice Address |
309 Kingsley Lake Dr # 901 St Augustine FL 32092-3047 |
| Mailing Address |
981 Kingsley Ave Orange Park FL 32073-4742 |
| Practice Telephone | 9042699595 |
| Practice Fax Number | 9042645211 |
| Mailing Telephone | 9042699595 |
| Mailing Fax Number | 9042645211 |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2020-07-29 |
| Authorized Official Name | GEORGE SAWDAY TELLAM (OWNER/PODIATRIST) |
| Authorized Official Telephone | 9042699595 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | PO 1636 | FL | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | INDIVIDUAL NPI | 1750319026 | 01 |
| Other Name | Type Code |
|---|---|
| Ankle & Foot Associates | Doing Business As Name - Organization |
| Street Address |
309 KINGSLEY LAKE DR # 901 |
| City | ST AUGUSTINE |
| State | FL |
| Zip Code | 32092-3047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205085107 | Imran Hyderali Rajwani | Family Medicine | 309 Kingsley Lake Dr, Suite No. 904, St Augustine, FL 32092-3047 | 2008-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124670146 | Kaitlyn Thomas | Speech-Language Pathologist | 111 Nature Walk Pkwy # B101, Saint Augustine, FL 32092 | 2019-07-10 |
| 1386168359 | Westminster Pines, Inc. | Skilled Nursing Facility | 235 Towerview Drive, St. Augustine, FL 32092 | 2017-08-01 |
| 1255852471 | St Vincent's Urgent Care Inc | Clinic/Center | 2001 Country Road 210 West, St Augustine, FL 32092 | 2017-06-28 |
| 1649702291 | Leonard Volpe | Physician Assistant | 745 Porta Rosa Cir, St Augustine, FL 32092 | 2017-04-03 |
| 1740630425 | Sierra Danielle Shultz | Behavioral Analyst | 2590 C H Arnold Rd, Saint Augustine, FL 32092 | 2016-06-14 |
| 1023467347 | Marylin Palackel James | Family Medicine | 110 Hampton Point Dr, St Augustine, FL 32092 | 2016-06-07 |
| 1790146462 | Florida Autism Center | Community/Behavioral Health | 124 Capulet Drive, St Augustine, FL 32092 | 2016-03-09 |
| 1174901458 | Kaylan Brady | Pediatrics | 70 Turin Terrace, Suite 220, St Augustine, FL 32092 | 2015-05-07 |
| 1245620368 | Angela Sanchez | Physician Assistant | 229 Adelanto Ave, St Augustine, FL 32092 | 2015-01-27 |
| 1053723700 | David Hamilton | Dentist | 149 Tuscan Way, St. Augustine, FL 32092 | 2014-05-29 |
| Find all providers in zip 32092 | ||||
| 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 |
|---|---|---|---|---|
| 1538646757 | Flagler Family Medicine P A | Podiatrist | 52 Tuscan Way Ste 205, St Augustine, FL 32092-1850 | 2018-07-20 |
| 1891178406 | John Randall Northrup | Podiatrist | 1690 Us Highway 1 S Ste C, St Augustine, FL 32084-6024 | 2015-06-30 |
| 1306032586 | Podiatry Associates of Florida Inc | Podiatrist | 220 Southpark Cir E, St Augustine, FL 32086-5135 | 2007-09-20 |
| 1184659484 | Victoria Jean Camp | Podiatrist | 1093 A1a Beach Blvd, Pmb 235, St Augustine, FL 32080-6733 | 2006-07-12 |
| 1275570897 | Jerry L Weed Jr. | Podiatrist | 3700 Us 1 S, St Augustine, FL 32086-7150 | 2006-06-01 |
| 1245277417 | John M Burns | Podiatrist | 1975 Old Moultrie Rd, St Augustine, FL 32086-5164 | 2006-05-31 |
| 1710987805 | Brett Cutler | Podiatrist | 105 Southpark Blvd, Ste A103, St Augustine, FL 32086-4162 | 2005-07-29 |
| 1932430667 | Health Park Podiatric Foot and Ankle Clinic, Inc | Podiatrist | 1975 Old Moultrie Rd, St Augustine, FL 32086-5164 | 2010-01-20 |
| 1114164456 | D.s.miles Dpm, Pa | Podiatrist | 220 Southpark Cir E, St Augustine, FL 32086-5135 | 2009-01-08 |
| 1245485259 | D.s. Miles Dpm, Pa | Podiatrist | 220 Southpark Cir E, St Augustine, FL 32086-5135 | 2008-11-19 |
| Find all providers in ST AUGUSTINE | ||||
| City | ST AUGUSTINE |
| Zip Code | 32092 |
Please comment or provide details below to improve the information on GEORGE S TELLAM.
| 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.