WOLF RIVER FAMILY FOOTCARE PLLC (NPI# 1457480683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457480683 |
| Entity Type | Organization |
| Organization Name | WOLF RIVER FAMILY FOOTCARE PLLC |
| Practice Address |
7424 Us Highway 64 Suite 119 Bartlett TN 38133-3986 |
| Practice Telephone | 9013812800 |
| Practice Fax Number | 9013812677 |
| Mailing Telephone | 9013812800 |
| Mailing Fax Number | 9013812677 |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2008-06-05 |
| Authorized Official Name | DR. CARL JOSEPH SICILIANO (OWNER SOLE MEMBER) |
| Authorized Official Telephone | 9013812800 |
| Authorized Official Credential | D.P.M. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
DPM0000000422 | TN | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | MEDICARE ID TYPE UNSPECIFIED | DG7179 | 01 |
| Street Address |
7424 US HIGHWAY 64 SUITE 119 |
| City | BARTLETT |
| State | TN |
| Zip Code | 38133-3986 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073764692 | Adam C Macevoy | Podiatrist | 7424 Us Highway 64, Bartlett, TN 38133-3986 | 2008-10-01 |
| 1578711131 | Lorena Beatriz Alvarez | Podiatrist | 7424 Us Highway 64, Suite 119, Bartlett, TN 38133-3986 | 2008-09-08 |
| 1154351278 | Fawn Cress | Nurse Practitioner | 7424 Us Highway 64, Suite 111, Bartlett, TN 38133-3986 | 2006-07-04 |
| 1922056431 | Carl J Siciliano | Podiatrist | 7424 Us Highway 64, Ste 119, Bartlett, TN 38135 | 2006-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568069201 | Warren Hilliard | Family Medicine | 7625 Hwy64, 107, Memphis, TN 38133 | 2020-10-06 |
| 1487142048 | David Charles Riddle | Pharmacist | 8400 Hwy 64, Bartlett, TN 38133 | 2018-04-28 |
| 1366943177 | Calandra White Shannon | Physical Therapist | 8025 Highway 64, Suite 102, Memphis, TN 38133 | 2018-02-27 |
| 1285144527 | Annice R.h. Overall | Social Worker | 2561 Sunny Glade Cove, Memphis, TN 38133 | 2017-09-30 |
| 1275050098 | Bartlett Asc, LLC | Clinic/Center | 3045 Kate Bond Road, Bartlett, TN 38133 | 2017-08-23 |
| 1407385297 | Tennessee Psychiatric Services Pllc | Psychiatry & Neurology | 2965 N Germantown Rd Ste 116, Bartlett, TN 38133 | 2017-06-06 |
| 1598113656 | Sensory World Memphis | Durable Medical Equipment & Medical Supplies | 2965 N Germantown Rd Suite 107, Bartlett, TN 38133 | 2016-05-31 |
| 1659754471 | Grant Coleman Dasher | Dentist | 2705 Appling Road Suite 101, Memphis, TN 38133 | 2015-06-30 |
| 1134533243 | Caelyn Newport | Chiropractor | 7879 Crescent Hill Dr., Memphis, TN 38133 | 2014-06-17 |
| 1033536479 | Lunceford Family Health Center | Internal Medicine | 7865 Edcator's Ln Suite 300, Bartlett, TN 38133 | 2014-03-24 |
| Find all providers in zip 38133 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124260575 | Steven K Chase D.p.m. P.C. | Podiatrist | 7174 Us Highway 64, 123, Bartlett, TN 38133-8954 | 2009-04-01 |
| 1619977006 | J.l. Wu, D.p.m., P.C. | Podiatrist | 108 W Bartlett Ave, Bartlett, IL 60103-4235 | 2005-07-28 |
| 1417256272 | Kyle S. Peterson | Podiatrist | 1110 W Schick Rd, Bartlett, IL 60103-3007 | 2011-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821623638 | Advanced Diagnostic Imaging PC | Podiatrist | 179 Hancock St Ste 300, Gallatin, TN 37066-6347 | 2020-03-12 |
| 1366099269 | Khumalo Foot and Ankle Clinic, Inc | Podiatrist | 1109 E Reelfoot Ave Ste D, Union City, TN 38261-5866 | 2019-08-25 |
| 1154889533 | Cutting Edge Foot and Ankle | Podiatrist | 3443 Dickerson Pike Ste 310, Nashville, TN 37207-2523 | 2019-03-05 |
| 1902376346 | Family Foot and Ankle Pllc | Podiatrist | 120 Walnut Commons Ln Ste A120, Cookeville, TN 38501-6035 | 2018-11-28 |
| 1649757238 | Healthstar Physicians, P.C. | Podiatrist | 2435 Jacksboro Pike Ste 3, La Follette, TN 37766-2912 | 2018-07-26 |
| 1851817290 | Tennessee Foot & Ankle Specialists PC | Podiatrist | 515 Highland Ter Ste B, Murfreesboro, TN 37130-2424 | 2017-08-17 |
| 1386165694 | Lucy Jayne Barrow | Podiatrist | 300 20th Ave N Ste 103, Nashville, TN 37203-2132 | 2017-06-28 |
| 1982051298 | Louis I Reper II | Podiatrist | 125 Town Creek Rd E Ste 3, Lenoir City, TN 37772 | 2016-05-17 |
| 1982050217 | Francois V. Dijour | Podiatrist | 111 Highway 70 E Ste G, Dickson, TN 37055-2080 | 2016-05-05 |
| 1447614136 | Sallee Taylor Randolph | Podiatrist | 1303 Sunset Dr Ste 6, Johnson City, TN 37604 | 2016-04-08 |
| Find all providers with the same taxonomy | ||||
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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.