KEITH BANGART DPM PC (NPI# 1699065839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699065839 |
| Entity Type | Organization |
| Organization Name | KEITH BANGART DPM PC |
| Practice Address |
13660 N 94th Dr Ste F1 Peoria AZ 85381-4232 |
| Practice Telephone | 6239740522 |
| Practice Fax Number | 6239335787 |
| Mailing Telephone | 6239740522 |
| Mailing Fax Number | 6239335787 |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2011-08-11 |
| Authorized Official Name | KEITH BANGART (PRESIDENT) |
| Authorized Official Telephone | 6239740522 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 0724 | AZ | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AZ LICENSE | 0724 | 01 |
| DEA | FB2444812 | 01 |
| Street Address |
13660 N 94TH DR STE F1 |
| City | PEORIA |
| State | AZ |
| Zip Code | 85381-4232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710471529 | Jeff Thomas Pllc | Podiatrist | 13660 N 94th Dr Ste F1, Peoria, AZ 85381-4232 | 2018-06-15 |
| 1710470950 | Shane Moore Dpm PC | Podiatrist | 13660 N 94th Dr Ste F1, Peoria, AZ 85381-4232 | 2018-06-12 |
| 1699276881 | Neo Matrix Anesthesia LLC | Anesthesiology | 13660 N 94th Dr Ste F1, Peoria, AZ 85381-4232 | 2018-02-23 |
| 1154822369 | Regenerative Foot & Ankle LLC | Clinic/Center | 13660 N 94th Dr Ste F1, Peoria, AZ 85381-4232 | 2018-02-22 |
| 1306101571 | Steven Shane Moore | Podiatrist | 13660 N 94th Dr Ste F1, Peoria, AZ 85381-4232 | 2012-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932712122 | Vicki L Grenier | Registered Nurse | 7558 W. Thunderbird Rd. Ste 1-507, Peoria, AZ 85381 | 2020-08-26 |
| 1568934107 | Earthwalk Wellness Group, LLC | Social Worker | 14050 North 83rd Avenue, Suite 290, Peoria, AZ 85381 | 2018-12-20 |
| 1316412059 | John & Biljana Feeley Dba J & B Assisted Living IIi Inc | Community Based Residential Treatment Facility, Mental Illness | 7331 W Sweetwater Avenue, Peoria, AZ 85381 | 2018-10-09 |
| 1467958611 | Arizona Community Pharmacy | Pharmacy | 14100 N 83rd Ave Ste 160, Peoria, AZ 85381 | 2018-04-04 |
| 1083112106 | Marissa Lynn Desjardins | Physical Therapist | 8240 W. Cactus Rd. Oakeson Physical Therapy, Peoria, AZ 85381 | 2018-01-23 |
| 1235651399 | Power Back Batteries LLC | Durable Medical Equipment & Medical Supplies | 9054 West Lisbon Ave, Peoria, AZ 85381 | 2017-07-11 |
| 1457897027 | Sonoran Sky Community Services | Community Based Residential Treatment Facility, Mental Illness | 7524 W. Alexandria Way, Peoria, AZ 85381 | 2017-01-06 |
| 1386023448 | Scott Boone | Registered Nurse | 7715 W Watson Ln, Peoria, AZ 85381 | 2015-05-22 |
| 1881084838 | Pinnacle Women's Center LLC | Obstetrics & Gynecology | 15396 N 83rd Ave Ste F100, Peoria, AZ 85381 | 2015-01-29 |
| 1245637081 | Kathi Locke | Counselor | 13460 N. 94th Drive, Suite J2, Peoria, AZ 85381 | 2014-11-21 |
| Find all providers in zip 85381 | ||||
| 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 |
|---|---|---|---|---|
| 1962689489 | Dan Bangart Plc | Podiatrist | 13660 N 94th Drive, Suite F-1, Peoria, AZ 85381-4323 | 2008-01-28 |
| 1770540700 | Teisha M Kubala | Podiatrist | 8325 W Happy Valley Rd, Unit 105, Peoria, AZ 85383-4361 | 2006-04-26 |
| 1285613463 | Thomas Kevin Brattain | Podiatrist | 3322 W Willow Knolls Dr, Peoria, IL 61614-8148 | 2006-01-16 |
| 1336135177 | David M Bates | Podiatrist | 15182 N 75th Ave, Ste 160, Peoria, AZ 85381-4722 | 2005-09-27 |
| 1689939985 | Annie Jong | Podiatrist | 13660 N 94th Dr, Ste A3, Peoria, AZ 85381-4836 | 2012-07-12 |
| 1306101571 | Steven Shane Moore | Podiatrist | 13660 N 94th Dr Ste F1, Peoria, AZ 85381-4232 | 2012-07-12 |
| 1013216373 | Keith Thomas Bangart | Podiatrist | 13660 N 94th Dr, #f1, Peoria, AZ 85381-4836 | 2011-03-24 |
| 1689978397 | Edward Au | Podiatrist | 9171 W Thunderbird Rd, Ste 101, Peoria, AZ 85381-4872 | 2011-01-10 |
| 1629208723 | John Charles Hart | Podiatrist | 300 E War Memorial Dr, Suite 200, Peoria, IL 61614-7570 | 2009-07-23 |
| 1982817912 | Achilles Heel LLC | Podiatrist | 13660 N 94th Dr, Ste A-3, Peoria, AZ 85381-4836 | 2007-05-07 |
| Find all providers in PEORIA | ||||
Please comment or provide details below to improve the information on KEITH BANGART DPM 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.