JONATHAN G SABOURIN (NPI# 1306809603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306809603 |
| Entity Type | Individual |
| Full Name | JONATHAN G SABOURIN |
| Credential | DPM |
| Practice Address |
850 Aquidneck Ave Ste 15 Middletown RI 02842-7280 |
| Practice Telephone | 4018492157 |
| Practice Fax Number | 4018488441 |
| Mailing Telephone | 4018492157 |
| Mailing Fax Number | 4018488441 |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2018-06-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | DPM00316 | RI | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
2210 | MA | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
DPM00316 | RI | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | 7056541 | 05 | |
| RI | BLUE CROSS BLUE SHIELD | 212867 | 01 |
| RI | BLUE CHIP | 411583 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 300 Hanover St Ste 2c, Fall River, MA 027205451 | 5082581717 | 7743656272 |
| Street Address |
850 AQUIDNECK AVE STE 15 |
| City | MIDDLETOWN |
| State | RI |
| Zip Code | 02842-7280 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427671478 | Shannon M. Pine | Counselor | E Admiralty Drive, 2, Middletown, RI 02842 | 2020-05-26 |
| 1912425968 | Gail Demarco | Registered Nurse | 127 Johnnycake Hill Road, Middletown, RI 02842 | 2017-08-30 |
| 1790201861 | Logan Christopher Menard | Specialist/Technologist | 4 Orville Drive, Middletown, RI 02842 | 2017-08-20 |
| 1295149714 | Jacquelyn Marez | Occupational Therapy Assistant | 1998 West Main Rd, Middletown, RI 02842 | 2014-06-12 |
| 1144660465 | Brittney Lea Barry | Audiologist | Naval Health Clinic New England 43 Smith Rd., Newport, RI 02842 | 2013-07-01 |
| 1912262445 | Wendy S Drysdale | Student in an Organized Health Care Education/Training Program | 372 Purgatory Road, St. George's School, Middletown, RI 02842 | 2012-07-11 |
| 1912294778 | Laurie B Phenix | Pharmacist | 88 Silva Lane, Tech 4, Suite 110, Middletown, RI 02842 | 2011-06-30 |
| 1023278249 | Ann Marie Efflandt | Speech-Language Pathologist | 333 Green Ave, Middletown, RI 02842 | 2008-06-11 |
| 1669631487 | Tiffany Bourquin | Counselor | 575 E Main Rd Unit 4, Middletown, RI 02842 | 2008-06-06 |
| 1104048396 | Valley Primary Care Inc | Family Medicine | 294 Valley Road, Middletown, RI 02842 | 2007-05-03 |
| Find all providers in zip 02842 | ||||
| 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 |
|---|---|---|---|---|
| 1851407837 | Barry Steven Lerner | Podiatrist | 453 Route 211 E, Middletown, NY 10940-2206 | 2006-08-22 |
| 1598735631 | William Christian Anania Sr. | Podiatrist | 112 Tindall Rd, Middletown, NJ 07748-2337 | 2006-01-23 |
| 1538149208 | Michael L Wodka | Podiatrist | 30 Industrial Dr, Middletown, NY 10941-1662 | 2006-01-19 |
| 1346236692 | Eric Jason Plumley | Podiatrist | 3913 Roosevelt Blvd, Middletown, OH 45044-6674 | 2005-09-22 |
| 1699779553 | Marc Klein | Podiatrist | 34 N Breiel Blvd, Middletown, OH 45042-3804 | 2005-06-09 |
| 1699203323 | Matthew J Waxman | Podiatrist | 118 Sandhill Dr Ste 204, Middletown, DE 19709 | 2017-05-25 |
| 1356877021 | Eric J Plumley Dpm | Podiatrist | 3913 Roosevelt Blvd, Middletown, OH 45044-6674 | 2017-05-02 |
| 1073929071 | Sussex Foot and Ankle Specialist,llc | Podiatrist | 110 E Main St, Middletown, NY 10940-5119 | 2014-07-10 |
| 1497000103 | Adebola Adeleke | Podiatrist | 512 Saybrook Rd, Ste 100, Middletown, CT 06457-4788 | 2012-07-18 |
| 1063792828 | Shane Baker | Podiatrist | 95 Crystal Run Rd, Middletown, NY 10941-7001 | 2011-08-25 |
| Find all providers in MIDDLETOWN | ||||
| City | MIDDLETOWN |
| Zip Code | 02842 |
Please comment or provide details below to improve the information on JONATHAN G SABOURIN.
| 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.