DR. MILLARD THOMAS HENNESSEE (NPI# 1285666222) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1285666222 |
Entity Type | Individual |
Full Name | DR. MILLARD THOMAS HENNESSEE |
Credential | D.P.M |
Practice Address |
654 E Broadway Boston MA 02127-1502 |
Practice Telephone | 6172681745 |
Practice Fax Number | 6172681748 |
Mailing Telephone | 6172681745 |
Mailing Fax Number | 6172681748 |
Enumeration Date | 2006-07-07 |
Last Update Date | 2012-08-16 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 213E00000X | Podiatrist | 001614 | MA | Podiatric Medicine & Surgery Service Providers |
N | 332B00000X | Durable Medical Equipment & Medical Supplies | 001614 | MA | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MA | BLUE SHIELD | Y70691 | 01 |
MA | 0341487 | 05 |
Street Address |
654 E BROADWAY |
City | BOSTON |
State | MA |
Zip Code | 02127-1502 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598370629 | Peaceful Healing Soul Counseling Center, LLC | Counselor | Online Therapy, Boston, MA 02127 | 2020-09-15 |
1568964914 | Phuong Luu | Nurse Practitioner | 606 E Fourth St, Unit 204, Boston, MA 02127 | 2018-03-01 |
1700304367 | Kelsey L Donovan | Physician Assistant | 431 E 3rd Street Apt 2, Boston, MA 02127 | 2017-09-05 |
1255873733 | Janet Villafane | Social Worker | 23 Mcdonough Way, 691, Boston, MA 02127 | 2016-11-15 |
1083088470 | Katie Ryan | Counselor | 8 Rev Burke Street #151, South Boston, MA 02127 | 2015-11-23 |
1184005514 | Keith A Lombard | Counselor | 1226a Columbia Rd., South Boston, MA 02127 | 2015-06-11 |
1609213917 | Nicole Ashley Vandermay | Student in an Organized Health Care Education/Training Program | 9 Woodward St, Apt. 3, Boston, MA 02127 | 2013-05-28 |
1922359777 | Elizabeth Raggi | Counselor | 49 L Street, South Boston, MA 02127 | 2012-09-19 |
1205181021 | Massachusetts General Hospital | General Acute Care Hospital | 256 West Sixth Street Apt 2, South Boston, MA 02127 | 2012-07-18 |
1154602126 | Madeline F Brisotti | Counselor | 8 Reverend Burke Steet, South Boston, MA 02127 | 2011-09-06 |
Find all providers in zip 02127 |
Taxonomy Code | 213E00000X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306138086 | Daphne Robert | Podiatrist | 732 Harrison Ave Bldg 5th, Boston, MA 02118-2309 | 2011-05-12 |
1487644936 | Carol A Divaio | Podiatrist | 55 Fruit St Yaw 3056, Podiatry Group, Boston, MA 02114-2696 | 2005-10-26 |
1285623694 | David E. Negron | Podiatrist | 732 Harrison Avenue, Preston 5th Floor, Boston, MA 02118 | 2005-10-18 |
1356339949 | Judy Beth Hurwitz | Podiatrist | 66 Charles St, #528, Boston, MA 02114-4604 | 2005-10-08 |
1558353714 | David Agoada | Podiatrist | 133 Brookline Ave., Hvma, Boston, MA 02215 | 2005-08-15 |
1407854094 | Adam Scott Landsman | Podiatrist | 55 Fruit Street, Dept. of Orthopaedics/podiatry Service, Boston, MA 02114-2696 | 2005-07-08 |
1538791892 | Seniorwell Pod of Massachusetts LLC | Podiatrist | 75 Arlington St Ste 500, Boston, MA 02116-3936 | 2020-02-05 |
1023672979 | Lowell Tong | Podiatrist | 185 Pilgrim Rd, Boston, MA 02215-5324 | 2019-04-25 |
1689026023 | Gurneet Khangura | Podiatrist | 55 Fruit St, Yawkey 3f, Boston, MA 02114-2621 | 2016-07-11 |
1548527518 | Wei M Tseng | Podiatrist | 732 Harrison Ave, Preston Family Building 5th Floor, Boston, MA 02118-2309 | 2012-04-16 |
Find all providers in BOSTON |
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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.