DR. MACK JAY GROVES IV (NPI# 1265460877) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265460877 |
| Entity Type | Individual |
| Full Name | DR. MACK JAY GROVES IV |
| Other Name | JAY GROVES IV |
| Credential | DPM |
| Practice Address |
323 S Tyler St Covington LA 70433-3037 |
| Mailing Address |
802 W 10th Ave Suite 2 Covington LA 70433-2352 |
| Practice Telephone | 9858679605 |
| Practice Fax Number | 9858679001 |
| Mailing Telephone | 9858679605 |
| Mailing Fax Number | 9858679001 |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2019-09-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213E00000X | Podiatrist | PD190R | LA | Podiatric Medicine & Surgery Service Providers |
| Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
DPM.190R | LA | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
PD190R | LA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUECROSS | 1265460877 | 01 |
| Street Address |
323 S TYLER ST |
| City | COVINGTON |
| State | LA |
| Zip Code | 70433-3037 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942486741 | Foot & Ankle Health Center LLC | Podiatrist | 323 S Tyler St, Covington, LA 70433-2352 | 2008-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790301018 | Caroline K. Wilson | Speech-Language Pathologist | 19105 Sandy Lane Suite A, Covington, LA 70433 | 2020-06-23 |
| 1568092013 | Tracy T Aljabi | Nurse Practitioner | 648 Crestwood Dr., Covington, LA 70433 | 2020-01-23 |
| 1093365462 | Maria Robert Hebrock | Marriage & Family Therapist | 71338 La-21, Suite 101, Covington, LA 70433 | 2019-09-17 |
| 1750930806 | Terry Fink Troxler | Speech-Language Pathologist | 521 Covington Point Dr, Covington, LA 70433 | 2019-09-10 |
| 1780231589 | Margaret Nordness Favre | Behavioral Analyst | 3999 Us-190, Covington, LA 70433 | 2019-08-26 |
| 1881241180 | Jennifer Ann Bacile | Counselor | 604 E 15th Street, Covington, LA 70433 | 2019-08-21 |
| 1356906689 | Moving and Caring Transportation LLC | Non-emergency Medical Transport (VAN) | 251 Vintage Drive, Covington, LA 70433 | 2019-05-02 |
| 1780153874 | Nga Endoscopy Center LLC | Clinic/Center | 7015 Hwy 190 E Service Road Suite 103, Covington, LA 70433 | 2018-11-19 |
| 1831667229 | Geauxprodme | Durable Medical Equipment & Medical Supplies | 1304 Champagne Street, Covington, LA 70433 | 2018-11-05 |
| 1376037994 | Pamela Ann Bernabo | Specialist/Technologist, Other | 80 Maison Drive, Covington, LA 70433 | 2018-06-18 |
| Find all providers in zip 70433 | ||||
| Taxonomy Code | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366619199 | Paul W. Hutchison | Podiatrist | 1723 Highway 51 S Ste C, Covington, TN 38019-3628 | 2008-05-12 |
| 1770592453 | Michael R Kaye LLC | Podiatrist | 101 E Fairway Dr, Suite 206, Covington, LA 70433-7503 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669900916 | Richard Barkan Willner | Podiatrist | 3140 Garden Oaks Dr Ste 101, New Orleans, LA 70114-6745 | 2017-05-31 |
| 1417316258 | William Andress | Podiatrist | 385 Bert Kouns Loop Ste 200, Shreveport, LA 71106-8158 | 2016-02-22 |
| 1477517175 | Angelo P Morreale, Dpm, A Prof Corp | Podiatrist | 422 Dixie Plz, Natchitoches, LA 71457-5881 | 2006-04-12 |
| 1437159787 | Eunice V. Hodges | Podiatrist | 11143 Winchester Park Dr, New Orleans, LA 70128-2717 | 2005-07-28 |
| 1497362834 | Richard B Willner Dpm LLC | Podiatrist | 3140 Garden Oaks Dr Ste 101, New Orleans, LA 70114-6745 | 2020-09-29 |
| 1255735320 | Anthony I Blanchard Dpm LLC | Podiatrist | 1555 Gary Dr, Breaux Bridge, LA 70517-3448 | 2014-10-17 |
| 1295162980 | Advanced Foot Care LLC | Podiatrist | 831 Dublin St, New Orleans, LA 70118-1023 | 2013-09-26 |
| 1154693968 | Frederick Jacques Hall | Podiatrist | 510 E Stoner Ave, Shreveport, LA 71101-4243 | 2012-02-08 |
| 1154607117 | Joseph A. Delucca, Dpm, LLC | Podiatrist | 3101 Ridgelake Dr, Metairie, LA 70002-4926 | 2011-10-22 |
| 1609034859 | Trucly Chung Vu | Podiatrist | 1401 N Foster Dr, Lsu Diabetes Foot Program, Baton Rouge, LA 70806-1818 | 2008-05-23 |
| Find all providers with the same taxonomy | ||||
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| 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.