KORY DEE MISKIN (NPI# 1215376058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215376058 |
| Entity Type | Individual |
| Full Name | KORY DEE MISKIN |
| Credential | DPM |
| Practice Address |
601 Sw Regional Airport Blvd Bentonville AR 72713-9256 |
| Practice Telephone | 4795532664 |
| Mailing Telephone | 4795532664 |
| Mailing Fax Number | 4795532536 |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2020-09-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213E00000X | Podiatrist | 41000291A | IN | Podiatric Medicine & Surgery Service Providers |
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
41000291A | IN | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200681640A | 05 | |
| RR MEDICARE | P01765552 | 01 | |
| AR | 217669717 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 245 S 370 E, Smithfield, UT 843351423 | 8012349211 | |
| 1101 Jackson St Sw, Gravette, AR 727369121 | (479) 878-5221 | 4798789692 |
| Street Address |
601 SW REGIONAL AIRPORT BLVD |
| City | BENTONVILLE |
| State | AR |
| Zip Code | 72713-9256 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083768618 | Gregory Ryan Spears | Family Medicine | 601 Sw Regional Airport Blvd, Bentonville, AR 72713-9256 | 2007-01-22 |
| 1457716813 | Brian Daniel Melloy | Family Medicine | 601 Sw Regional Airport Blvd, Bentonville, AR 72713-9256 | 2015-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356834998 | Ashley Monet Mcelroy | Chiropractor | 2303 Sw Primrose Ave, Bentonville, AR 72713 | 2018-06-08 |
| 1528544749 | Chris Tingey | Occupational Therapist | 1601 Greenhouse Rd, Bentonville, AR 72713 | 2018-07-11 |
| 1558758730 | Erik Brian Sowell | Internal Medicine | 4100 Sw I St Ste 200, Bentonville, AR 72713 | 2015-04-24 |
| 1780238782 | Chelsea D. Marquis | Nurse Practitioner | 4401 Sw Flagstone Blvd, Bentonville, AR 72713-4005 | 2019-07-29 |
| 1922580901 | Deep Roots Health Center Inc | Chiropractor | 103 Sw Winsted Ln Ste 25, Bentonville, AR 72713-6203 | 2018-09-05 |
| 1477035459 | Ryan Carlson | Chiropractor | 103 Sw Winsted Ln Ste 25, Bentonville, AR 72713-6203 | 2018-09-05 |
| 1154921773 | Kathleen Hamblin | Pharmacist | 906 Sw Regional Airport Blvd, Bentonville, AR 72713-7364 | 2020-11-01 |
| 1245272939 | Twin Rivers Respiratory Care, Inc. | Durable Medical Equipment & Medical Supplies | 1805 Sw Regional Airport Blvd Ste 3&5, Bentonville, AR 72713-7755 | 2006-06-10 |
| 1487291415 | Rewild The Child Nwa, LLC | Occupational Therapist | 2003 Sw Regional Airport Blvd, Bentonville, AR 72713-7930 | 2019-12-10 |
| 1588276208 | Jessica Brooke Yocum | Occupational Therapy Assistant | 3902 Sw Boulder St Apt 27, Bentonville, AR 72713-8496 | 2020-08-24 |
| Find all providers in zip 72713 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528251956 | Charles Stephen Ginn | Podiatrist | 2703 Se G St, Suite 1, Bentonville, AR 72712-3740 | 2007-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649791369 | Kyle Haverstrom | Podiatrist | 200 S 20th St Ste B, Rogers, AR 72758-1100 | 2017-07-03 |
| 1609288984 | Aaron Teufel | Podiatrist | 1794 E Joyce Blvd Ste 2, Fayetteville, AR 72703 | 2014-05-21 |
| 1568716744 | Spencer Lewis Mortensen | Podiatrist | 1500 Dodson Ave Ste 260, Fort Smith, AR 72901-5179 | 2012-11-09 |
| 1982968574 | Adam Lloyd Bingham | Podiatrist | 1713 W Main St, Russellville, AR 72801-2721 | 2012-06-27 |
| 1477881092 | Bradley Footcare LLC | Podiatrist | 116 W Tyler Ave Ste B, West Memphis, AR 72301-4221 | 2009-11-19 |
| 1114160389 | Jesse H. Bradley Jr. | Podiatrist | 116 W Tyler Ave, Suite B, West Memphis, AR 72301-4221 | 2009-04-16 |
| 1154571495 | Mid-south Foot & Ankle Clinic P C | Podiatrist | 302 S Rhodes St, West Memphis, AR 72301-4215 | 2008-09-23 |
| 1235314147 | Stephanie A. Roth | Podiatrist | 703 W Main St, Russellville, AR 72801-3616 | 2008-01-09 |
| 1144341827 | Carlotta Monique Wells | Podiatrist | 1132 Malvern Ave, Hot Springs, AR 71901-6347 | 2007-04-02 |
| 1407936388 | Angela Lorraine Ayson | Podiatrist | 11 Halsted Cir Ste E, Rogers, AR 72756-3145 | 2006-10-16 |
| Find all providers with the same taxonomy | ||||
| City | BENTONVILLE |
| Zip Code | 72713 |
Please comment or provide details below to improve the information on KORY DEE MISKIN.
| 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.