DR. LARRY K CRUEL (NPI# 1609996982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609996982 |
| Entity Type | Individual |
| Full Name | DR. LARRY K CRUEL |
| Credential | DPM |
| Practice Address |
4510 Office Park Dr Jackson MS 39206-6016 |
| Practice Telephone | 6019813001 |
| Practice Fax Number | 6019818999 |
| Mailing Telephone | 6019813001 |
| Mailing Fax Number | 6019818999 |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2008-06-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
80152 | MS | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00120141 | 05 |
| Street Address |
4510 OFFICE PARK DR |
| City | JACKSON |
| State | MS |
| Zip Code | 39206-6016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235508623 | Fondren Health Clinic | Clinic/Center | 4510 Office Park Dr, Jackson, MS 39206-6016 | 2015-09-16 |
| 1497957120 | Advanced Foot Care Center | Podiatrist | 4510 Office Park Dr, Jackson, MS 39206-6016 | 2007-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023661824 | Latoya Lanette Trunell | Occupational Therapy Assistant | 787 East Northside Drive, Jackson, MS 39206 | 2019-07-20 |
| 1649839291 | Andrew Harris | Dentist | 4505 I-55 Frontage Rd. N, Jackson, MS 39206 | 2019-06-07 |
| 1679065916 | Savannah Lee Zachry | Physical Therapist | 5140 Galaxie Dr Ste 108, Jackson, MS 39206 | 2018-06-02 |
| 1669987723 | Harmony House Calls LLC | Nurse Practitioner | 5140 Galaxie Dr Ste 105, Jackson, MS 39206 | 2017-12-11 |
| 1841719903 | Yolanda Yvette Bell | Nurse Practitioner | 6064 Whitestone Rd, Jackson, MS 39206 | 2017-09-10 |
| 1760907117 | Anthony Brown Jr. | Physical Therapist | 5411 I-55 North, Jackson, MS 39206 | 2017-08-07 |
| 1114457132 | Ambric N Williams | Occupational Therapy Assistant | 6017 Whitestone Rd, Jackson, MS 39206 | 2017-06-13 |
| 1952835613 | Peak Chiropractic Care, LLC | Chiropractor | 4915 I-55 North, Suite 201b, Jackson, MS 39206 | 2017-04-19 |
| 1447798293 | Peterkin and Associates of Mississippi Inc | Community/Behavioral Health | 5155 Galaxie Drive, Suite F, Jackson, MS 39206 | 2017-02-01 |
| 1952844219 | Jennifer Penick | Counselor | 460 Briarwood Drive, Suite 510, Jackson, MS 39206 | 2016-11-18 |
| Find all providers in zip 39206 | ||||
| Taxonomy Code | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972537041 | Willie James Lewis Sr. | Podiatrist | 128 Poindexter St, Jackson, MS 39203-3048 | 2006-07-11 |
| 1497957120 | Advanced Foot Care Center | Podiatrist | 4510 Office Park Dr, Jackson, MS 39206-6016 | 2007-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336594985 | Nkechinyere Christina Nwoko | Podiatrist | 46 Sgt Prentiss Dr Ste 201b, Natchez, MS 39120 | 2016-05-02 |
| 1770942146 | Sarah Lynn Freed | Podiatrist | 9065 Sandidge Center Cv Ste C, Olive Branch, MS 38654-3574 | 2016-02-15 |
| 1740309590 | Madison Foot Clinic, Pllc | Podiatrist | 980 Highway 51 Ste B, Madison, MS 39110-8409 | 2007-03-29 |
| 1386715514 | Bruce K. Boyd | Podiatrist | 211 Alcorn Dr, Corinth, MS 38834-8400 | 2006-11-10 |
| 1144316092 | Foot Clinic of Hattiesburg, P.a. | Podiatrist | 710 S 28th Ave, Ste B, Hattiesburg, MS 39402-2585 | 2006-10-05 |
| 1376561779 | Ricky Roach | Podiatrist | 999 N Halstead Rd, Ocean Springs, MS 39564-3105 | 2006-07-17 |
| 1790779858 | Rose Marie Sotolongo | Podiatrist | 731 S Pear Orchard Rd, Suite 7, Ridgeland, MS 39157-4800 | 2005-09-06 |
| 1598037798 | Oh for Feet Sake, LLC. | Podiatrist | 368 Scarbrough St, Suite B, Richland, MS 39218-9038 | 2012-02-02 |
| 1962538082 | Stephanie Fay Phelan | Podiatrist | 587 Highway 51 Ste T2, Ridgeland, MS 39157-2506 | 2007-02-25 |
| 1578661633 | Cleveland Foot Clinic Inc | Podiatrist | 140 North St, Cleveland, MS 38732-2744 | 2006-09-20 |
| 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.