SAM BAZRAFSHAN (NPI# 1417314477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417314477 |
| Entity Type | Individual |
| Full Name | SAM BAZRAFSHAN |
| Credential | D.P.M. |
| Practice Address |
4308 Brainerd Rd Chattanooga TN 37411 |
| Mailing Address |
900 Circle 75 Pkwy Se Suite 900 Atlanta GA 30339-3035 |
| Practice Telephone | 4236981966 |
| Practice Fax Number | 4236977207 |
| Mailing Telephone | 6784262171 |
| Mailing Fax Number | 4044461957 |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2018-05-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 790 | TN | Podiatric Medicine & Surgery Service Providers |
| N | 213E00000X | Podiatrist | POD001307 | GA | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
PR349 | FL | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q023367 | 05 |
| Street Address |
4308 BRAINERD RD |
| City | CHATTANOOGA |
| State | TN |
| Zip Code | 37411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972666766 | Advanced Foot Care LLP | Podiatrist | 4308 Brainerd Rd, Chattanooga, TN 37411-5424 | 2006-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811520620 | Winzetta Jenkins | Social Worker | 5705 Uptain Rd., Chattanooga, TN 37411 | 2020-02-20 |
| 1881156651 | Valerie L Radu | Social Worker | 5800 Uptain Road, Suite 1200, Chattanooga, TN 37411 | 2019-04-02 |
| 1568986693 | Solution Transportation Services, Inc | Non-emergency Medical Transport (VAN) | 4707 North Terrace, Chattanooga, TN 37411 | 2017-07-31 |
| 1689060733 | Nirlepkumar Patel | Pharmacist | 3602 Brainerd Road, Chattanooga, TN 37411 | 2015-04-15 |
| 1669896254 | Audra Valentaviciene | Nurse Practitioner | 5618 Brainerd Road, Chattanooga, TN 37411 | 2014-02-18 |
| 1376973198 | Kelly Leigh Kennedy | Nurse Practitioner | 5600 Brainerd Road, Suite B14, Chattanooga, TN 37411 | 2013-11-14 |
| 1417210071 | Jason Owen Blair | Physical Therapy Assistant | 5779 Brainard Rd, Chattanooga, TN 37411 | 2012-06-19 |
| 1447532270 | Masons and Daughter LLC | Non-emergency Medical Transport (VAN) | 7 North Tuxedo Ave, Chattanooga, TN 37411 | 2011-09-19 |
| 1841500386 | Pamela Denise Stultz | Physical Therapy Assistant | 3207 Rosemont Drive, Chattanooga, TN 37411 | 2010-10-18 |
| 1689803843 | Pauline Evans | Occupational Therapy Assistant | 1557 Pin Oak Dr, Chattanooga, TN 37411 | 2009-07-09 |
| Find all providers in zip 37411 | ||||
| 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 |
|---|---|---|---|---|
| 1780072371 | Special Care Podiatry of Tennessee, LLC | Podiatrist | 6140 E Brainerd Rd, Chattanooga, TN 37421-3910 | 2015-01-05 |
| 1992048938 | Advanced Foot Care, LLP | Podiatrist | 3742 Tennessee Ave, Suite 108, Chattanooga, TN 37409-1215 | 2013-03-28 |
| 1215166384 | Joy Danae Russell | Podiatrist | 5701 Brainerd Rd, Suite 111, Chattanooga, TN 37411-4016 | 2009-07-09 |
| 1740334325 | Cynthia Smallman Eby | Podiatrist | 4512 Dayton Blvd, Chattanooga, TN 37415-2148 | 2007-01-22 |
| 1598853970 | Michael Todd Wiles | Podiatrist | 5959 Shallowford Rd Ste 213, Chattanooga, TN 37421-2215 | 2006-10-10 |
| 1932118643 | Robert G. Walters | Podiatrist | 1720 Gunbarrel Rd Ste 204, Chattanooga, TN 37421-3192 | 2006-08-05 |
| 1316969215 | Rivercity Podiatry, PC | Podiatrist | 3107 Ozark Cir, Chattanooga, TN 37415-5105 | 2006-07-23 |
| 1902843154 | Mario S. Dickens | Podiatrist | 6116 Shallowford Rd, Ste 118, Chattanooga, TN 37421-7201 | 2006-05-31 |
| 1063479350 | Dennis Luke Bizzoco | Podiatrist | 1007 Spring Creek Rd, Chattanooga, TN 37412 | 2006-04-28 |
| 1780683136 | David Q Anderson | Podiatrist | 3742 Tennessee Ave Ste 108, Chattanooga, TN 37409 | 2005-07-19 |
| Find all providers in CHATTANOOGA | ||||
| City | CHATTANOOGA |
| Zip Code | 37411 |
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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.