J W PODIATRY PC (NPI# 1629294020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629294020 |
| Entity Type | Organization |
| Organization Name | J W PODIATRY PC |
| Practice Address |
22 Christy Dr 5 Brockton MA 02301-1839 |
| Practice Telephone | 5085864444 |
| Practice Fax Number | 5085864449 |
| Mailing Telephone | 5085864444 |
| Mailing Fax Number | 5085864449 |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2012-07-10 |
| Authorized Official Name | DR. W ANTHONY WAKIM (OWNER) |
| Authorized Official Telephone | 5085864444 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
MA | Podiatric Medicine & Surgery Service Providers |
| Street Address |
22 CHRISTY DR 5 |
| City | BROCKTON |
| State | MA |
| Zip Code | 02301-1839 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538286703 | Neurocare, Inc. | Clinic/Center | 22 Christy Dr, Brockton, MA 02301-1839 | 2007-03-23 |
| 1316497191 | Monique Mitchell | Clinical Nurse Specialist | 22 Christy Dr, Brockton, MA 02301-1839 | 2016-10-05 |
| 1831427632 | Leslie Ann Delisle | Clinical Nurse Specialist | 22 Christy Dr, Brockton, MA 02301-1839 | 2009-12-07 |
| 1841527603 | Linda M. Palmer | Registered Nurse | 22 Christy Dr, Brockton, MA 02301-1839 | 2009-11-14 |
| 1508010034 | Sarah White Darling | Psychologist | 22 Christy Dr, Brockton, MA 02301 | 2008-11-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807110 | Jenny Vulpis | Recreation Therapist | 940 Belmont St (br 135), Brockton, MA 02301 | 2020-10-01 |
| 1205444924 | Caroline Storey | Counselor | Men's Addiction Treatment Center, 10 Meadowbrook Road, Brockton, MA 02301 | 2020-07-20 |
| 1013546852 | Nuria Dos Santos Veiga | Occupational Therapist | 73 Denton St, Brockton, MA 02301 | 2020-04-03 |
| 1679113930 | Laura Ann Brondyk II | Counselor | 10 Christys Dr, Brockton, MA 02301 | 2020-01-14 |
| 1437796521 | Andrea Lopes | Developmental Therapist | 7 Goddard Road, Brockton, MA 02301 | 2019-12-08 |
| 1518420124 | Diligencehealthcare | Psychiatry & Neurology | 30-40 Westpark Street, Brockton, MA 02301 | 2019-04-10 |
| 1124530373 | Rachel Theys | Behavioral Analyst | 130 Liberty St Ste 13a, Brockton, MA 02301 | 2017-10-27 |
| 1689193369 | Anderson D Delgado | Behavior Technician | 11 Packard Way, Brockton, MA 02301 | 2017-09-14 |
| 1811415326 | Francesca Lavecchia | Clinical Neuropsychologist | Brockto Area Multi Service, Inc. 10 Christy Dr., Brockton, MA 02301 | 2017-09-05 |
| 1831615343 | Donna Marie Dugan | Counselor | South Bay Community Services, 340 Main Street - Suite 818, Worcester, MA 02301 | 2017-08-16 |
| Find all providers in zip 02301 | ||||
| Taxonomy Code | 213ES0131X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962686329 | Bridgewater Goddard Park Medical Associates Podiatry Division | Podiatrist | 110 Liberty St, Brockton, MA 02301-5521 | 2007-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043746878 | Faezeh Bakhtiari-nejad | Podiatrist | 223 Concord Tpke Unit 219, Cambridge, MA 02140-2338 | 2017-05-11 |
| 1679966584 | Melrose Family Foot Care Group | Podiatrist | 533 Franklin St, Melrose, MA 02176-1742 | 2015-03-17 |
| 1366795023 | Matthew P. Butler, D.p.m. LLC | Podiatrist | 1153 Centre Street, Suite # 5980, Brigham and Women's Faulkner Hospital, Boston, MA 02130 | 2012-10-18 |
| 1518141035 | Richard S. Donela | Podiatrist | 900 State Rd, North Adams, MA 01247-3030 | 2007-12-19 |
| 1962685396 | Cecilia G. Moore Dpm LLC | Podiatrist | 214 Orleans Rd, Suite C, North Chatham, MA 02650-3101 | 2007-12-07 |
| 1932145810 | Mark Paul Sanphy | Podiatrist | 98 Nahant St, Lynn, MA 01902-3315 | 2006-06-21 |
| 1154385078 | Matthew P Butler | Podiatrist | 340 Maple Street, Suite 405, Marlborough, MA 01752 | 2006-04-17 |
| 1083675573 | Susan M Walsh | Podiatrist | 981 Canton Ave, Milton, MA 02186-3621 | 2006-04-01 |
| 1316914971 | Bruce Treadwell Croft | Podiatrist | 795 Main St, Holden, MA 01520-3800 | 2006-03-02 |
| 1255301891 | James Gerard Cataldo | Podiatrist | 14 Manning Ave, Suite 302, Leominster, MA 01453-5768 | 2006-01-25 |
| 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.