PERSONAL FOOTCARE LLC (NPI# 1487613030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487613030 |
| Entity Type | Organization |
| Organization Name | PERSONAL FOOTCARE LLC |
| Practice Address |
2020 Wakefield Ave Petersburg VA 23805-2112 |
| Practice Telephone | 8047321211 |
| Practice Fax Number | 8047335946 |
| Mailing Telephone | 8047321211 |
| Mailing Fax Number | 8047335946 |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2007-10-04 |
| Authorized Official Name | DR. SAMUEL WINFRED PERSON (PRESIDENT) |
| Authorized Official Telephone | 8047321211 |
| Authorized Official Credential | D.P.M. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
0103000377 | VA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VT | 009331409 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861746059 | Personal Footcare LLC | Durable Medical Equipment & Medical Supplies | 424 Bracey Ln, South Hill, VA 23970-1631 | 2012-11-09 |
| Street Address |
2020 WAKEFIELD AVE |
| City | PETERSBURG |
| State | VA |
| Zip Code | 23805-2112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154324879 | Samuel Winfred Person | Podiatrist | 2020 Wakefield Ave, Petersburg, VA 23805-2112 | 2005-05-27 |
| 1548662935 | Personal Foot Care II, LLC | Podiatrist | 2020 Wakefield Ave, Petersburg, VA 23805-2112 | 2014-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134690647 | Miles Viant | Occupational Therapist | 287 E Blvd, Petersburg, VA 23805 | 2018-12-10 |
| 1245756964 | Dexter Shabazz Lett | Registered Nurse | 10543 S. Crater Rd, S. Prince George, VA 23805 | 2017-08-15 |
| 1891145876 | Taylor Enhanced Living | Counselor | 105 Holly Hill Dive, Suite A, Petersburg, VA 23805 | 2016-06-21 |
| 1700255205 | Ina Thompson | Counselor | 272 Medical Park Boulevard, Petersburg, VA 23805 | 2015-09-15 |
| 1932582541 | Valeria Edda Madrid Malo Bohorquez | Internal Medicine | 50 Medical Park Blvd Ste C, Petersburg, VA 23805 | 2015-06-30 |
| 1548642788 | Justin Andrew Phillingane | Podiatrist | 3335 S Crater Rd Ste 500, Petersburg, VA 23805 | 2015-06-24 |
| 1225417082 | Paladin Dermatology LLC | Nurse Practitioner | 44 A& B Medical Park Blvd, Petersburg, VA 23805 | 2015-05-27 |
| 1245652544 | Family Services Inc. | Health Maintenance Organization | 1045 Gustavo Lane, Petersburg, VA 23805 | 2014-01-06 |
| 1619268075 | Charlene Belangia | Massage Therapist | 3323 S. Crater Rd, Suite B, Petersburg, VA 23805 | 2011-04-20 |
| 1760709638 | Caresouth Hha Holdings of Virginia, LLC | Home Health | 34 Medical Park Boulevard, Suite G-h, Petersburg, VA 23805 | 2010-04-30 |
| Find all providers in zip 23805 | ||||
| Taxonomy Code | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154324879 | Samuel Winfred Person | Podiatrist | 2020 Wakefield Ave, Petersburg, VA 23805-2112 | 2005-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528598281 | James H Chung | Podiatrist | 2826 Old Lee Hwy Ste 220, Fairfax, VA 22031-4348 | 2017-06-15 |
| 1750730628 | Podiatry Home Care LLC | Podiatrist | 1567 Aspin Ave, Suite B, Norfolk, VA 23502-1532 | 2016-06-10 |
| 1922405174 | Hampton Roads Foot & Ankle Clinic | Podiatrist | 17 Moore Rd, Poquoson, VA 23662-1105 | 2014-12-02 |
| 1295171858 | Thomas John Davidson Iv | Podiatrist | 1331 Hamilton Ter Se, Roanoke, VA 24014-1805 | 2013-05-21 |
| 1881955243 | Foothold Podiatry | Podiatrist | 1417 Claiborne St, Richmond, VA 23220-6431 | 2012-06-01 |
| 1356497622 | Benedict A Profera | Podiatrist | 1589 Innsbrooke Dr, Salem, VA 24153-1785 | 2007-01-26 |
| 1922170919 | Foot Care of Hampton Roadspc | Podiatrist | 4317 Ainslie Ct S, Suffolk, VA 23434-7007 | 2006-11-14 |
| 1104997600 | David Elwood Detwiler | Podiatrist | 1232 Ty Bluff Road, Forest, VA 24551-1851 | 2006-11-13 |
| 1689776114 | Rodney A Kander | Podiatrist | 14200 Milltown Rd, Lovettsville, VA 20180-3314 | 2006-09-04 |
| 1255343083 | John G Piacenti | Podiatrist | 1416 Shenandoah Pkwy, Chesapeake, VA 23320-8137 | 2006-08-12 |
| Find all providers with the same taxonomy | ||||
| City | PETERSBURG |
| Zip Code | 23805 |
Please comment or provide details below to improve the information on PERSONAL FOOTCARE LLC.
| 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.