DR. MILLARD THOMAS HENNESSEE


Address: 654 E Broadway, Boston, MA 02127-1502
Phone: 6172681745

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
MA BLUE SHIELD Y70691 01
MA 0341487 05

Office Location

Street Address 654 E BROADWAY
City BOSTON
State MA
Zip Code 02127-1502

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NPI Name Taxonomy Address Enumeration
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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
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Taxonomy Information

Taxonomy Code 213E00000X
Grouping Podiatric Medicine & Surgery Service Providers
Classification Podiatrist

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Competitor

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City BOSTON
Zip Code 02127

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Dataset Information

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.

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