DR. TODD LEE DIVAN (NPI# 1235201898) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235201898 |
| Entity Type | Individual |
| Full Name | DR. TODD LEE DIVAN |
| Credential | DPM |
| Practice Address |
1415 E Reelfoot Ave Union City TN 38261-5812 |
| Practice Telephone | 7318850220 |
| Practice Fax Number | 7318850216 |
| Mailing Telephone | 7318850220 |
| Mailing Fax Number | 7318850216 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2013-05-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
734 | TN | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
016-004761 | IL | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS INSURANCE | 09206992 | 01 |
| IL | 016-004-761 | 05 | |
| IL | PALMETTO - MEDICARE | 480019679 | 01 |
| Street Address |
1415 E REELFOOT AVE |
| City | UNION CITY |
| State | TN |
| Zip Code | 38261-5812 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740744465 | Upperline Healthcare, PC | Podiatrist | 1415 E Reelfoot Ave, Union City, TN 38261-5812 | 2019-01-27 |
| 1053690958 | Feet First Podiatry PC | Podiatrist | 1415 E Reelfoot Ave, Union City, TN 38261-5812 | 2011-08-09 |
| 1962618488 | Stephen D Raines | Durable Medical Equipment & Medical Supplies | 1415 E Reelfoot Ave, Union City, TN 38261-5812 | 2007-05-14 |
| 1144393604 | Stephen D Raines | Podiatrist | 1415 E Reelfoot Ave, Union City, TN 38261-5812 | 2006-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437540200 | Brandi N Rose | Nurse Practitioner | 1109 E Reelfoot Ave Ste A, Union City, TN 38261 | 2015-02-13 |
| 1750719605 | Hannah V Burke | Nurse Practitioner | 1312 Bishop Street, Union City, TN 38261 | 2013-10-30 |
| 1548413545 | Vip Transpotation | Non-emergency Medical Transport (VAN) | 3888 Ken-tenn Hwy, Union City, TN 38261 | 2008-11-04 |
| 1902052137 | Michelle Davis Hudspeth | Speech-Language Pathologist | 1105 Sunswept Drive, Union City, TN 38261 | 2008-08-07 |
| 1053581744 | Terrell Clinic LLC | Nurse Practitioner | 701 East Reelfoot Ave, Suite 100, Union City, TN 38261 | 2008-03-10 |
| 1275673212 | Kristy Anne Mclaughlin | Counselor | 108 S 1st St, Union City, TN 38261 | 2007-02-07 |
| 1407900970 | Johnny R Miller Dmd Family Dentistry Inc | Dentist | 1209 Russell St, Union City, TN 38261 | 2007-01-22 |
| 1235223017 | Gabriel Paul Sullivan | Dentist | 1007 E Reelfoot Ave, Union City, TN 38261 | 2006-10-03 |
| 1003900887 | Gabe Sullivan Dds Plc | Dentist | 1007 East Reelfoot Ave, Union City, TN 38261 | 2006-10-03 |
| 1144312521 | Bhekumuzi Mcglen Khumalo | Podiatrist | 1190 E. Reelfoot Ave, Suite D, Union City, TN 38261 | 2006-09-29 |
| Find all providers in zip 38261 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366099269 | Khumalo Foot and Ankle Clinic, Inc | Podiatrist | 1109 E Reelfoot Ave Ste D, Union City, TN 38261-5866 | 2019-08-25 |
| 1144312521 | Bhekumuzi Mcglen Khumalo | Podiatrist | 1190 E. Reelfoot Ave, Suite D, Union City, TN 38261 | 2006-09-29 |
| 1801909817 | Lenny Ramirez | Podiatrist | 540 37th St, Union City, NJ 07087-2545 | 2006-08-16 |
| 1972856029 | Advanced Regional Foot Clinic Pllc | Podiatrist | 1720 E Reelfoot Ave, Suite 204, Union City, TN 38261-6047 | 2012-10-25 |
| 1811257165 | Stacy E. Iles | Podiatrist | 540 37th St, Union City, NJ 07087-2545 | 2012-05-21 |
| 1619236874 | Elham Nasab | Podiatrist | 4808 Bergenline Ave, Ste 202, Union City, NJ 07087-5162 | 2012-05-09 |
| 1285904490 | Jonathan Purisima Dpm, LLC | Podiatrist | 1005 New York Ave, Union City, NJ 07087-4127 | 2012-01-04 |
| 1053690958 | Feet First Podiatry PC | Podiatrist | 1415 E Reelfoot Ave, Union City, TN 38261-5812 | 2011-08-09 |
| 1508003534 | Jonathan Grecia Purisima | Podiatrist | 1005 New York Ave, Union City, NJ 07087-4127 | 2009-01-13 |
| 1356527154 | Raymond Maimone Dpm | Podiatrist | 415 39th St, Union City, NJ 07087-4817 | 2008-01-11 |
| Find all providers in UNION CITY | ||||
| City | UNION CITY |
| Zip Code | 38261 |
Please comment or provide details below to improve the information on DR. TODD LEE DIVAN.
| 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.