BLACKMUN FOOTCARE LLC (NPI# 1255620340) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1255620340 |
Entity Type | Organization |
Organization Name | BLACKMUN FOOTCARE LLC |
Practice Address |
2608 N 14th St Saint Louis MO 63106-3913 |
Mailing Address |
Po Box 23359 Saint Louis MO 63156-3359 |
Practice Telephone | 3149321570 |
Mailing Telephone | 3149321570 |
Enumeration Date | 2011-03-29 |
Last Update Date | 2016-04-05 |
Authorized Official Name | DR. ANNESSA RENEE' BLACKMUN (OWNER) |
Authorized Official Telephone | 5024184809 |
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 |
2010035799 | MO | Podiatric Medicine & Surgery Service Providers |
Street Address |
2608 N 14TH ST |
City | SAINT LOUIS |
State | MO |
Zip Code | 63106-3913 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770027997 | Superior Manor of Downtown LLC | Assisted Living Facility | 1501 Clinton St., St Louis, MO 63106 | 2016-12-07 |
1811361454 | James Preston Jr. | Pharmacist | 915 N. Grand Vlvd, Pharmacy Dept., John Cochran Va Medical Center, Saint Louis, MO 63106 | 2015-11-19 |
1245656354 | Julie Marie Albsmeyer | Physician Assistant | 915 North Grand 111-jc-gi, John Cochran Va Hospital, St. Louis, MO 63106 | 2014-03-13 |
1932523230 | Cathy Yeung | Registered Nurse | 715 N Grand Blvd., St Louis, MO 63106 | 2014-02-07 |
1902149388 | Amanda Foley | Doula | 4056 Humphrey Street, Saint Louis, MO 63106 | 2013-04-03 |
1942569876 | Cornelia Charles | Internal Medicine | 915 Norh Grand Blvd, Saint Louis, MO 63106 | 2012-05-12 |
1124334396 | Kasandra Ann Tinajero | Registered Nurse | 915 N. Grand Blvd., St. Louis, MO 63106 | 2010-08-26 |
1366673931 | Cassandra Vernetta Talbert | Social Worker | 915 N. Grand., 122/jc Social Work Dept. V.a. Medical Center, St. Louis, MO 63106 | 2009-07-30 |
1497910707 | Robert Louis Tillman | Pharmacy Technician | 915 N Grand Ave, St. Louis, MO 63106 | 2008-07-25 |
1861676686 | Bradley Dean Overmeyer | Social Worker | 915 N Grand Blvd., Social Work Service, St. Louis, MO 63106 | 2007-12-28 |
Find all providers in zip 63106 |
Taxonomy Code | 213ES0103X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
Specialization | Foot & Ankle Surgery |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851923023 | Center for Advanced Foot & Ankle Surgery, Inc. | Podiatrist | 3915 Watson Rd Ste 200, Saint Louis, MO 63109-1251 | 2020-02-06 |
1518486885 | Sunflower Podiatry and Wellness | Podiatrist | 1316 Hebert Street, Saint Louis, MO 63107 | 2017-09-18 |
1669745501 | West County Foot and Ankle LLC | Podiatrist | 10004 Kennerly Rd Ste 300a, Saint Louis, MO 63128 | 2012-02-22 |
1053623058 | Camille Patrice Ryans | Podiatrist | 11056 Oak Spur Ct Apt K, Saint Louis, MO 63146-1973 | 2010-07-07 |
1437314812 | Raymond Angelo Brickhouse Jr. | Podiatrist | 3535 S Jefferson Ave Ste 201, Saint Louis, MO 63118-3922 | 2008-07-24 |
1114068988 | Dr. Veda E. Lewis-simmons Dpm Mha LLC | Podiatrist | 10421 W Florissant Ave, Saint Louis, MO 63136-2342 | 2007-02-12 |
1346389095 | Foot & Ankle Center, LLC | Podiatrist | 11066 Olive Blvd, Saint Louis, MO 63141-7615 | 2007-02-06 |
1548325533 | Mid-west Podiatry & Associates, LLC | Podiatrist | 2 Millstone Campus Dr, Saint Louis, MO 63146-5776 | 2006-12-27 |
1477668606 | Nicolas Clay Martin | Podiatrist | 12639 Old Tesson Rd Ste 115, Saint Louis, MO 63128 | 2006-08-20 |
1275589038 | Vincent J Staschiak | Podiatrist | 8637 Delmar Blvd, Saint Louis, MO 63124-1906 | 2006-05-25 |
Find all providers in SAINT LOUIS |
City | SAINT LOUIS |
Zip Code | 63106 |
Please comment or provide details below to improve the information on BLACKMUN FOOTCARE 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.