LISA C OVERTON (NPI# 1356397913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356397913 |
| Entity Type | Organization |
| Organization Name | LISA C OVERTON |
| Practice Address |
1940 E Walnut Ln Philadelphia PA 19138-1312 |
| Practice Telephone | 2155482113 |
| Practice Fax Number | 2155483009 |
| Mailing Telephone | 2155482113 |
| Mailing Fax Number | 2155483009 |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2011-09-02 |
| Authorized Official Name | DR. LISA CAROL OVERTON (PODIATRIST) |
| Authorized Official Telephone | 2155482010 |
| Authorized Official Credential | D.P.M. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | SC004492L | PA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | MEDICARE RAILROAD ID | P00041340 | 01 |
| PA | ELDER HEALTH ID | 10741 | 01 |
| PA | DMERC SUPPLIER ID | 5403600001 | 01 |
| PA | 0018442730002 | 05 | |
| PA | HIGH MARK BLUE SHIELD ID | 001444333 | 01 |
| PA | 10 DIGIT IBC HMO ID | 2134337000 | 01 |
| Street Address |
1940 E WALNUT LN |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19138-1312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598000127 | Michal Desiree Moore | Massage Therapist | 1940 E Walnut Ln, Philadelphia, PA 19138-1312 | 2012-12-08 |
| 1619923190 | Lisa Carol Overton | Podiatrist | 1940 E Walnut Ln, Philadelphia, PA 19138-1312 | 2006-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043788227 | Clinica Pharmacy Inc | Pharmacy | 7157 Ogontz Ave, Philadelphia, PA 19138 | 2018-11-06 |
| 1184152308 | Prime Choice Dental, Inc | Dentist | 7155 Ogontz Ave, Philadelphia, PA 19138 | 2017-06-01 |
| 1063950376 | Prodigy Home Care | Home Health | 6137 Limekiln Pike, Phiadelphia, PA 19138 | 2017-02-07 |
| 1194275313 | William Gary George Jr. | Marriage & Family Therapist | 7101 N 20th St., Phila, PA 19138 | 2016-10-12 |
| 1790234490 | Gary Downing | Counselor | 5702 Boyer St., Philadelphia, PA 19138 | 2016-09-23 |
| 1093153785 | Northwest Medical & Rehabilitation Center PC | Internal Medicine | 6315 Stenton Ave, Philadelphia, PA 19138 | 2013-06-05 |
| 1902045586 | America's Best Contacts & Eyeglasses | Technician/Technologist | 5301 Chew Ave. B1, Philadelphia, PA 19138 | 2009-02-05 |
| 1588848477 | Tasha Carol Smith | Licensed Practical Nurse | 6947 Cedarpark Avenue, Phiadelphia, PA 19138 | 2007-12-27 |
| 1730107970 | Gregory Alan Nelson | Internal Medicine | 6315-17 Stenton Avenue, Philadelphia, PA 19138 | 2006-07-17 |
| 1588699706 | Michael D Helzner | Family Medicine | 1909/17 E Washington Lane, Philadelphia, PA 19138 | 2006-07-12 |
| Find all providers in zip 19138 | ||||
| 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 |
|---|---|---|---|---|
| 1912543109 | Kimberly Nguyen Dpm PC | Podiatrist | 1930 S Broad St Ste 19, Philadelphia, PA 19145-2328 | 2019-11-21 |
| 1811476658 | David Khakshoor | Podiatrist | 1703 Borbeck Ave Fl 1, Philadelphia, PA 19111-3514 | 2018-08-13 |
| 1851877179 | Andrew Mermelstein | Podiatrist | 5800 Roxborough Avenue, Philadelphia, PA 19128 | 2018-07-19 |
| 1053835264 | Marvin Marcelin | Podiatrist | 5735 Ridge Ave Ste 208, Philadelphia, PA 19128-1747 | 2017-07-29 |
| 1598287054 | Taylor Wasserleben | Podiatrist | 235 N Broad St Ste 300, Philadelphia, PA 19107-1511 | 2017-07-16 |
| 1952718975 | Travon Owens | Podiatrist | 4522 Westminster Ave, Philadelphia, PA 19131-5213 | 2014-07-22 |
| 1558675801 | Duane Romana | Podiatrist | 1865 Welsh Rd, Apt J-9, Philadelphia, PA 19115-4764 | 2010-07-28 |
| 1144532748 | Kimberly Hoang Nguyen | Podiatrist | 1311 South St, Philadelphia, PA 19147-1867 | 2010-07-12 |
| 1396973152 | Kwasi Y Kwaadu | Podiatrist | 148 N 8th Street, Philadelphia, PA 19107-2496 | 2009-06-30 |
| 1043453996 | Foot Health Centers, Pa | Podiatrist | 6911 Castor Ave, Philadelphia, PA 19149-1702 | 2009-04-08 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19138 |
Please comment or provide details below to improve the information on LISA C OVERTON.
| 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.