HEALTHDRIVE PODIATRY GROUP, PC (NPI# 1679504427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679504427 |
| Entity Type | Organization |
| Organization Name | HEALTHDRIVE PODIATRY GROUP, PC |
| Other Organization Name | HEALTHDRIVE PODIATRY GROUP |
| Practice Address |
200 S Executive Dr Suite 101 Brookfield WI 53005-4216 |
| Mailing Address |
100 Crossing Blvd Suite 300 Framingham MA 01702-5555 |
| Practice Telephone | 4145358134 |
| Practice Fax Number | 4145358135 |
| Mailing Telephone | 6179646681 |
| Mailing Fax Number | 3396862561 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2020-04-16 |
| Authorized Official Name | DR. SHADI ADIB ABBOUD (TREASURER/PRACTICE DIRECTOR) |
| Authorized Official Telephone | 8572550486 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 43264300 | 05 | |
| WI | MEDICARE RAILROAD | CD2116 | 01 |
| Other Name | Type Code |
|---|---|
| HealthDrive Podiatry Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083268866 | Healthdrive Podiatry Group, PC | Durable Medical Equipment & Medical Supplies | 12940 Harriet Ave S Ste 230, Burnsville, MN 55337-2794 | 2019-07-30 |
| 1689613598 | Healthdrive Podiatry Group, PC | Prosthetic/Orthotic Supplier | 100 Crossing Blvd, Suite 300, Framingham, MA 01702-5555 | 2006-06-06 |
| 1558915330 | Healthdrive Podiatry Group, PC | Durable Medical Equipment & Medical Supplies | 7600 France Ave S Ste 1100, Edina, MN 55435-5936 | 2019-07-30 |
| 1689228470 | Healthdrive Podiatry Group, PC | Durable Medical Equipment & Medical Supplies | 3883 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2518 | 2019-07-30 |
| 1548685258 | Healthdrive Podiatry Group, PC | Podiatrist | 6700 Alexander Bell Dr, Suite 200, Columbia, MD 21046-2122 | 2014-03-04 |
| 1326220674 | Healthdrive Podiatry Group, PC | Prosthetic/Orthotic Supplier | 12 Penns Trail, Suite 154, Newtown, PA 18940-3438 | 2007-11-28 |
| 1013106533 | Healthdrive Podiatry Group, PC | Podiatrist | 103 Carnegie Ctr, Suite 300, Princeton, NJ 08540-6235 | 2007-10-22 |
| 1831388354 | Healthdrive Podiatry Group, PC | Podiatrist | 100 Crossing Blvd, Suite 300, Framingham, MA 01702-5555 | 2007-10-22 |
| 1851580377 | Healthdrive Podiatry Group, PC | Podiatrist | 100 Crossing Blvd, Suite 300, Framingham, MA 01702-5555 | 2007-10-22 |
| 1134310188 | Healthdrive Podiatry Group, PC | Prosthetic/Orthotic Supplier | 101 Centerpoint Dr Ste 215, Middletown, CT 06457-7568 | 2007-08-06 |
| Street Address |
200 S EXECUTIVE DR SUITE 101 |
| City | BROOKFIELD |
| State | WI |
| Zip Code | 53005-4216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326079716 | Jeffrey L. Morer, Od, PC | Optometrist | 200 S Executive Dr, Suite 101, Brookfield, WI 53005-4216 | 2006-07-05 |
| 1174140115 | Krista Lyn Fogltanz | Audiologist | 200 S Executive Dr, Brookfield, WI 53005-4216 | 2020-06-25 |
| 1053953984 | Neuropsychological Services of Southeastern Wisconsin, Ltd | Clinical Neuropsychologist | 200 S Executive Dr, Brookfield, WI 53005-4216 | 2019-10-11 |
| 1265968036 | Crystal Avery | In Home Supportive Care | 200 S Executive Dr, Suite 101, Brookfield, WI 53005-4216 | 2017-05-11 |
| 1275914483 | Legacy Physiatry Group Wisconsin, LLC | Internal Medicine | 200 S Executive Dr, Suite 101, Brookfield, WI 53005-4216 | 2015-06-12 |
| 1629377676 | Maria Christine Jenkins | Dental Hygienist | 200 S Executive Dr, Suite 101, Brookfield, WI 53005-4216 | 2011-03-16 |
| 1124338462 | Genevieve Pressman | Pedorthist | 200 S Executive Dr, Suite 101, Brookfield, WI 53005-4216 | 2010-10-20 |
| 1679886915 | Natasha Marie Ming | Dental Hygienist | 200 S Executive Dr, Suite 101, Brookfield, WI 53005-4216 | 2010-07-15 |
| 1447589783 | Ryan R. Blair | Hearing Instrument Specialist | 200 S Executive Dr, Suite 101, Brookfield, WI 53005-4216 | 2009-12-16 |
| 1679802409 | Impressions of Increase, Inc. | In Home Supportive Care | 200 S Executive Dr, Suite 101, Brookfield, WI 53005-4216 | 2009-12-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154937621 | Nsk Precision Healing & Wellness | Acupuncturist | 17040 W. Greenfield Ave #6, Brookfield, WI 53005 | 2020-09-21 |
| 1033772124 | Dbt Consultants LLC | Social Worker | 200 S. Executive Drive, Ste. 101, Brookfield, WI 53005 | 2019-04-15 |
| 1780142588 | Ashley Wing | Registered Nurse | 405 Bishops Way, Apt 555, Brookfield, WI 53005 | 2019-03-11 |
| 1407370398 | Tombolo, LLC | Clinic/Center | 12545 W. Burleigh Rd., Suite 10, Brookfield, WI 53005 | 2017-08-01 |
| 1720509045 | Rss William Conner LLC | Dentist | 15455 W Bluemound Rd Ste 250, Brookfield, WI 53005 | 2017-06-28 |
| 1669926598 | Mackenzie Rondeau | Physical Therapist | 1905 N Calhoun Rd Ste 105, Brookfield, WI 53005 | 2016-08-09 |
| 1699159319 | Charles Alan Kass | Dentist | 12720 W. North Avenue, Brookfield, WI 53005 | 2015-07-13 |
| 1164804274 | Mary-catherine Nimphius | Counselor | 250 S. Sunny Slope Rd, #128, Brookfield, WI 53005 | 2015-06-25 |
| 1528447034 | Weighless Md, LLC | Dietitian, Registered | 14960 W. Greenfield Ave Suite 104, Brookfield, WI 53005 | 2015-05-29 |
| 1366837346 | Maegan Michelle Cook | Dentist | 13780 W Greenfield Ave Ste 780, Brookfield, WI 53005 | 2015-04-06 |
| Find all providers in zip 53005 | ||||
| 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 |
|---|---|---|---|---|
| 1447866033 | Podiatric Management Systems LLC | Podiatrist | 9230 Broadway Ave, Brookfield, IL 60513-1252 | 2020-09-18 |
| 1780081984 | Dr Kathleen M Schafer Dpm Inc | Podiatrist | 9230 Broadway Ave, Brookfield, IL 60513-1252 | 2014-12-03 |
| 1114157955 | Demetria Martin | Podiatrist | 200 S Executive Dr, Suite 101, Brookfield, WI 53005-4216 | 2009-07-14 |
| 1235287079 | Cynthia Jeanne Cornelius | Podiatrist | 246 Federal Rd, Ste C21, Brookfield, CT 06804-2647 | 2007-01-08 |
| 1336205939 | Brookfield Podiatry | Podiatrist | 246 Federal Rd, Suite C-21, Brookfield, CT 06804-2647 | 2006-12-28 |
| 1992803886 | Jeffrey Alan Hengel | Podiatrist | 200 S Executive Dr, Suite 101, Brookfield, WI 53005-4216 | 2006-09-21 |
| 1902905888 | Andrew Angelo Sengos | Podiatrist | 200 S Executive Dr, Suite 101, Brookfield, WI 53005-4216 | 2006-09-21 |
| 1730287657 | Renae Ann Luer | Podiatrist | 200 S Executive Dr, Suite 101, Brookfield, WI 53005-4216 | 2006-09-21 |
| 1346287505 | Kathleen Marie Schafer | Podiatrist | 9230 Broadway Ave, Brookfield, IL 60513-1252 | 2006-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161976 | Family Foot and Ankle Clinic LLC | Podiatrist | 1901 Westwood Boulevard, Wausau, WI 54401 | 2020-07-09 |
| 1588282453 | Family Foot and Ankle Clinic LLC | Podiatrist | 1021 Western Ave Ste C, Mosinee, WI 54455-1511 | 2020-07-08 |
| 1376161240 | Family Foot and Ankle Clinic LLC | Podiatrist | 1439 Churchill St Ste 202, Waupaca, WI 54981-2089 | 2020-07-08 |
| 1083237754 | Baycare Clinic LLP | Podiatrist | 630 Riverfront Dr, Sheboygan, WI 53081-4615 | 2020-05-28 |
| 1922637107 | Torhorst Foot and Ankle Clinic, Sc | Podiatrist | 2823 Post Rd, Stevens Point, WI 54481-6416 | 2020-04-08 |
| 1528446713 | Jonathan Shih | Podiatrist | 9200 W Loomis Rd Ste 116, Franklin, WI 53132 | 2015-05-08 |
| 1912310152 | Wyatt Isaac Wiedenfeld | Podiatrist | 853 S Main St, Oconto Falls, WI 54154-1203 | 2014-06-05 |
| 1710397039 | Kristina Lorene Thompson | Podiatrist | 37868 Us-18, Prairie Du Chien, WI 53821 | 2014-05-08 |
| 1972856169 | Midwest Foot and Wound Care Center LLC | Podiatrist | W3853 Stoneridge Dr, Fond Du Lac, WI 54937-6201 | 2012-10-25 |
| 1073880936 | Tahir A Khan | Podiatrist | 6001 W Center St Ste 108, Milwaukee, WI 53210-2154 | 2011-11-21 |
| Find all providers with the same taxonomy | ||||
| City | BROOKFIELD |
| Zip Code | 53005 |
Please comment or provide details below to improve the information on HEALTHDRIVE PODIATRY GROUP, PC.
| 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.