DR. STACIE QUINN FESSETTE (NPI# 1336328673) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336328673 |
| Entity Type | Individual |
| Full Name | DR. STACIE QUINN FESSETTE |
| Credential | DPM |
| Practice Address |
2835 W De Leon St Suite #101 Tampa FL 33609-4130 |
| Practice Telephone | 8132546592 |
| Practice Fax Number | 8132543634 |
| Mailing Telephone | 8132546592 |
| Mailing Fax Number | 8132543634 |
| Enumeration Date | 2007-11-02 |
| Last Update Date | 2011-07-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
PO3325 | FL | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE PTAN | CQ633Y | 01 | |
| FL | RR MEDICARE | P00829933 | 01 |
| FL | MEDIARE PTAN | CQ633Z | 01 |
| FL | BCBS | 65A03 | 01 |
| Street Address |
2835 W DE LEON ST SUITE #101 |
| City | TAMPA |
| State | FL |
| Zip Code | 33609-4130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952306755 | Edward Bruce Kampsen | Otolaryngology | 2835 W De Leon St, #202, Tampa, FL 33609-4130 | 2005-06-17 |
| 1114305935 | Casey Overturf | Physician Assistant | 2835 W De Leon St, Ste 103, Tampa, FL 33609-4130 | 2015-05-13 |
| 1326313545 | Rebecca E Wilder | Physical Therapist | 2835 W De Leon St, Suite 205, Tampa, FL 33609-5518 | 2012-03-21 |
| 1245532316 | Vein Specialists of Tampa LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2835 W De Leon St, Suite 206, Tampa, FL 33609-4130 | 2010-11-23 |
| 1316253982 | Benjamin Mena, M.d. P.a. | Internal Medicine | 2835 W De Leon St, Suite 104, Tampa, FL 33609-4130 | 2010-08-20 |
| 1336303353 | Podiatry Network of Florida | Exclusive Provider Organization | 2835 W De Leon St, Suite 101, Tampa, FL 33609-4130 | 2008-07-18 |
| 1487846499 | Jose Antonio Sanchez Md | Internal Medicine | 2835 W De Leon St, Suite 203, Tampa, FL 33609-4130 | 2007-08-14 |
| 1396936076 | Tracy Alan Jones | Massage Therapist | 2835 W De Leon St, Suite 204, Tampa, FL 33609-4130 | 2007-08-07 |
| 1538368493 | Kaf Path LLC | Clinical Medical Laboratory | 2835 W De Leon St, Suite 103, Tampa, FL 33609-4130 | 2007-07-12 |
| 1699971804 | Edward B Kampsen Md Pa | Otolaryngology | 2835 W De Leon St, #202, Tampa, FL 33609-4130 | 2007-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427521970 | Kampsen Hearing LLC | Audiologist | 310 South Macdill Avenue, Suite 202, Tampa, FL 33609 | 2019-01-08 |
| 1629557319 | Priscilla Luna-mitchum | Physical Therapist | 2700 W M.l.k Jr Blvd, Suite 300, Tampa, FL 33609 | 2018-08-13 |
| 1043735657 | Mary Elizabeth Osbach | Registered Nurse | 3211 W Swann Ave, Unit 1106, Tampa, FL 33609 | 2017-08-04 |
| 1497275317 | Jeilyn M Jimenez | Developmental Therapist | 550 N Reo Street, Tampa, FL 33609 | 2017-06-21 |
| 1033658513 | Adela Reeb | Specialist/Technologist | 909 North Dale Mabry Hwy, Tampa, FL 33609 | 2017-02-17 |
| 1033561261 | Abigail Marie Richardson | Developmental Therapist | 555 North Reo Street, Tampa, FL 33609 | 2016-07-12 |
| 1275992448 | Jennifer Stich | Behavioral Analyst | 3210 W De Leon St # B, Tampa, FL 33609 | 2016-02-16 |
| 1154711505 | Health E Systems, LLC | Transportation Broker | 5100 W. Lemon Street, Suite 311, Tampa, FL 33609 | 2015-01-23 |
| 1619375292 | Healthexchange Systems, LLC | Home Health | 5100 West Lemon Street, Suite 311, Tampa, FL 33609 | 2014-12-12 |
| 1538567458 | Calvin Harrison Iv | Occupational Therapist | 600 N. Westshore Blvd, Suite 600, Tampa, FL 33609 | 2014-12-09 |
| Find all providers in zip 33609 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114211299 | Megan Brook Johnson | Podiatrist | 13019 W Linebaugh Ave Ste 101, Tampa, FL 33626 | 2011-06-06 |
| 1437207933 | All Podiatry Group Inc | Podiatrist | 2511 W. Dr Martin L. King Blvd., Tampa, FL 33607 | 2007-01-08 |
| 1225103260 | Richard Steven Salkowe | Podiatrist | 4130 Carrollwood Village Dr, Tampa, FL 33618-8626 | 2006-11-22 |
| 1831288554 | Bernard Goldstein | Podiatrist | 13615 Bruce B Downs Blvd, Suite 112, Tampa, FL 33613-4607 | 2006-10-12 |
| 1942238829 | Paul A Beyer | Podiatrist | 13349 N 56th St, Tampa, FL 33617-1161 | 2006-06-29 |
| 1124080866 | James Russell Lowrey | Podiatrist | 8583 W Linebaugh Ave, Tampa, FL 33625-3731 | 2006-04-06 |
| 1629573217 | Tidewater Foot & Ankle Associates, Inc. | Podiatrist | 13019 W Linebaugh Ave Ste 101, Tampa, FL 33626 | 2018-03-27 |
| 1831619956 | Michal Waldman Dpm Pa | Podiatrist | 1706 E Bearss Ave, Tampa, FL 33613-2451 | 2017-06-20 |
| 1043743800 | Michael Birau | Podiatrist | 13000 Bruce B Downs Blvd, Tampa, FL 33612-4745 | 2017-04-09 |
| 1740726959 | Kussel & Associates | Podiatrist | 1302 W Swann Ave, Tampa, FL 33606-2531 | 2017-01-11 |
| Find all providers in TAMPA | ||||
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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.