GRAND FORKS FOOT AND ANKLE CLINIC, PLLC (NPI# 1164647822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164647822 |
| Entity Type | Organization |
| Organization Name | GRAND FORKS FOOT AND ANKLE CLINIC, PLLC |
| Practice Address |
1451 44th Ave S Ste 128d Grand Forks ND 58201-3434 |
| Practice Telephone | 7017382770 |
| Mailing Telephone | 7017382770 |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2008-03-14 |
| Authorized Official Name | DR. JOHN CARLYLE MILLER (PRESIDENT) |
| Authorized Official Telephone | 7017382770 |
| 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 |
48 | ND | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 13707 | 05 | |
| ND | BLURE CROSS BLUE SHIELD | 06740-001 | 01 |
| Street Address |
1451 44TH AVE S STE 128D |
| City | GRAND FORKS |
| State | ND |
| Zip Code | 58201-3434 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255965398 | Development Homes Inc | Intermediate Care Facility, Mentally Retarded | 5509 Cottonwood Street, Grand Forks, ND 58201 | 2020-02-27 |
| 1932753779 | Lydia Pansegrau | Occupational Therapist | 2950 36th Ave S, Apt A-11, Grand Forks, ND 58201 | 2019-07-30 |
| 1407416019 | Kristina Aikens | Optometrist | 1820 S 42nd St, Grand Forks, ND 58201 | 2019-06-17 |
| 1861963209 | Jessica Kovsky | Occupational Therapist | 1375 S Columbia Rd- Altru Performance Center, Grand Forks, ND 58201 | 2018-12-11 |
| 1609345834 | Altru Specialty Services, Inc | Durable Medical Equipment & Medical Supplies | 1375 South Columbia Road, Suite A, Grand Forks, ND 58201 | 2018-11-16 |
| 1225523004 | Alicia Mae Mack | Registered Nurse | 212 S. 4th St. Suite 301, Spectra Health, Grand Forks, ND 58201 | 2018-06-25 |
| 1396260808 | Amber White | Behavior Technician | 2016 S Washington St., Grand Forks, ND 58201 | 2017-08-04 |
| 1225579840 | Kathleen Suzanne Tillman | Psychologist | 2100 S Columbia Road, Suite 202, Family Institute, PC, Grand Forks, ND 58201 | 2017-03-15 |
| 1881148906 | Melissa Pytlik Monson | Physician Assistant | 1380 S Columbia Rd - Altru Family Medcine Center, Grand Forks, ND 58201 | 2016-08-05 |
| 1477936029 | Laura Jane Carlson | Nurse Practitioner | 3165 Demers Avenue - Truyu Aesthetic Center, Grand Forks, ND 58201 | 2015-07-01 |
| Find all providers in zip 58201 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346669082 | Yashraj Chauhan | Podiatrist | 3035 Demers Ave, Grand Forks, ND 58201 | 2014-04-09 |
| 1407810575 | John Carlyle Miller | Podiatrist | 3035 Demers Ave, Grand Forks, ND 58201-4040 | 2006-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073979845 | Capital Foot and Ankle | Podiatrist | 136 W Edmonton Dr, Bismarck, ND 58503-0224 | 2016-01-11 |
| 1902873458 | Brian D Gale | Podiatrist | 1733 E Capitol Ave, Bismarck, ND 58501-2150 | 2006-03-03 |
| 1649240557 | Clark J Fullmer II | Podiatrist | 2615 Fairway St, Dickinson, ND 58601 | 2006-01-24 |
| 1962753749 | Accessible Podiatry, P.C. | Podiatrist | 3 4th St E, Suite 102, Williston, ND 58801-5350 | 2012-09-20 |
| 1023363587 | Robert Renschler | Podiatrist | 1702 South University Drive, Eh South University Clinic, Fargo, ND 58103-4940 | 2012-07-19 |
| 1043574460 | Rachael Renschler | Podiatrist | 2422 20th St Sw, Jamestown, ND 58401-6201 | 2012-06-29 |
| 1487917340 | John Paul Naughton | Podiatrist | 1720 University Dr S, Fargo, ND 58103-4940 | 2012-06-15 |
| 1487945630 | Guy K Slann | Podiatrist | 3 4th St E, Suite 102, Williston, ND 58801-5350 | 2011-04-22 |
| 1295044212 | Aaron J Albers | Podiatrist | 101 3rd Ave Sw, Minot, ND 58701-3880 | 2010-09-26 |
| 1215244041 | Gregory Iwaasa | Podiatrist | 401 N 9th St, Bismarck, ND 58501-4530 | 2010-08-31 |
| Find all providers with the same taxonomy | ||||
| City | GRAND FORKS |
| Zip Code | 58201 |
Please comment or provide details below to improve the information on GRAND FORKS FOOT AND ANKLE CLINIC, PLLC.
| 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.