SANDY RIVER PODIATRY, PA (NPI# 1336367416) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336367416 |
| Entity Type | Organization |
| Organization Name | SANDY RIVER PODIATRY, PA |
| Practice Address |
114 Perham St Farmington ME 04938-1520 |
| Practice Telephone | 2077791002 |
| Practice Fax Number | 2077791091 |
| Mailing Telephone | 2077791002 |
| Mailing Fax Number | 2077791091 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2009-09-16 |
| Authorized Official Name | DR. JEFFREY JOHNSON (OWNER) |
| Authorized Official Telephone | 2077791002 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | POD1034 | ME | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 134880000 | 05 |
| Street Address |
114 PERHAM ST |
| City | FARMINGTON |
| State | ME |
| Zip Code | 04938-1520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831704964 | Cary Rae Millbury | Social Worker | 16 Middle Street, Farmington, ME 04938 | 2020-09-15 |
| 1538615224 | Woodlands Senior Living of Farmington, LLC | Alzheimer Center (Dementia Center) | 175 Knowlton Corner Rd., Farmington, ME 04938 | 2016-09-01 |
| 1740617158 | Jason Pratt | Pharmacist | 624 Wilton Road, Farmington, ME 04938 | 2013-09-30 |
| 1194050195 | New Communities, Inc. | Assisted Living Facility | 136 Rosewood Drive, Farmington, ME 04938 | 2009-10-08 |
| 1477787364 | Jennifer Zeliger | Obstetrics & Gynecology | Franklin Health Women's Care, 181 Franklin Health Commons, Farmington, ME 04938 | 2009-05-07 |
| 1649412602 | Work First, Inc. | Day Training, Developmentally Disabled Services | 309 Wilton Road, 309 Wilton Road, Farmington, ME 04938 | 2009-04-06 |
| 1598943110 | Peter W Swallow | Dentist | 107 Box Shop Hill, Farmington, ME 04938 | 2008-02-06 |
| 1477620706 | Scott D Christie | Psychologist | 176 Livermore Falls Road, Farmington, ME 04938 | 2006-11-30 |
| 1104900836 | Angela M Thompson | Social Worker | 144 High Street, Ste 1, Farmington, ME 04938 | 2006-10-25 |
| 1124101464 | Evergreen Behavioral Services | Clinic/Center | 131 Franklin Health Commons, Suite A Mt Blue Health Center, Farmington, ME 04938 | 2006-10-23 |
| Find all providers in zip 04938 | ||||
| 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 |
|---|---|---|---|---|
| 1710175872 | J Garey Ritchie | Podiatrist | 904 E 20th St Ste C, Farmington, NM 87401-4281 | 2007-10-13 |
| 1891836243 | David S Ungar Dpm PC | Podiatrist | 34435 Grand River, Farmington, MI 48335 | 2007-02-09 |
| 1528172871 | Samuel C Carpenter | Podiatrist | 304 S Lake St, Ste 104, Farmington, NM 87401-5659 | 2006-08-17 |
| 1093743502 | Brian Keith Wagner | Podiatrist | 11 South Rd Lowr Level20, Farmington, CT 06032-2483 | 2006-06-30 |
| 1467424168 | Jeffrey M. Tencer | Podiatrist | 1055 Farmington Ave, Farmington, CT 06032-1511 | 2006-02-06 |
| 1801896816 | Gary A Green | Podiatrist | 670 Shepard Ln, Suite 102, Farmington, UT 84025-3936 | 2005-08-01 |
| 1699775015 | David Sam Ungar | Podiatrist | 34435 Grand River Ave, Farmington, MI 48335-3309 | 2005-07-28 |
| 1295112464 | Nighat Hussain | Podiatrist | 263 Farmington Avenue, Farmington, CT 06030-4038 | 2015-04-27 |
| 1871812057 | Scott W. Lindsay, Dpm | Podiatrist | 1055 Farmington Ave, Farmington, CT 06032-1573 | 2010-05-27 |
| 1497823348 | Scott William Lindsay | Podiatrist | 1055 Farmington Ave, Farmington, CT 06032-1511 | 2006-11-30 |
| Find all providers in FARMINGTON | ||||
| City | FARMINGTON |
| Zip Code | 04938 |
Please comment or provide details below to improve the information on SANDY RIVER PODIATRY, PA.
| 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.