DR. KELSEY MAE SUKOVATY (NPI# 1700308095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700308095 |
| Entity Type | Individual |
| Full Name | DR. KELSEY MAE SUKOVATY |
| Credential | DPM |
| Practice Address |
3421 W 9th St Waterloo IA 50702-5401 |
| Mailing Address |
3735 Ravenwood Cir Apt 10 Waterloo IA 50702-5521 |
| Practice Telephone | 3192728000 |
| Mailing Telephone | 5153703321 |
| Enumeration Date | 2017-07-09 |
| Last Update Date | 2017-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
088135 | IA | Podiatric Medicine & Surgery Service Providers |
| Street Address |
3421 W 9TH ST |
| City | WATERLOO |
| State | IA |
| Zip Code | 50702-5401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740287614 | Nicholas J Goetsch | Family Medicine | 3421 W 9th St, Waterloo, IA 50702-5401 | 2005-07-06 |
| 1770101263 | Aaron Russell Haubrich | Podiatrist | 3421 W 9th St, Waterloo, IA 50702-5401 | 2020-07-10 |
| 1629694682 | Nadia Nikoueiha | Podiatrist | 3421 W 9th St, Waterloo, IA 50702-5401 | 2020-06-24 |
| 1386278117 | Kirre Hannan | Pharmacist | 3421 W 9th St, Waterloo, IA 50702-5401 | 2020-03-02 |
| 1265094239 | Samuel Bernard | Podiatrist | 3421 W 9th St, Waterloo, IA 50702-5401 | 2019-07-01 |
| 1306408125 | Trent Boyer | Podiatrist | 3421 W 9th St, Waterloo, IA 50702-5401 | 2019-07-01 |
| 1467017921 | John Jacob Zion Kelly | Nurse Practitioner | 3421 W 9th St, Waterloo, IA 50702-5401 | 2019-05-09 |
| 1003381963 | Tyler James Goebel | Pharmacist | 3421 W 9th St, Waterloo, IA 50702-5401 | 2018-10-08 |
| 1164907465 | Samantha Wheeler | Pharmacist | 3421 W 9th St, Waterloo, IA 50702-5401 | 2018-10-02 |
| 1063992857 | Kevin J Dirksen | Nurse Practitioner | 3421 W 9th St, Waterloo, IA 50702-5401 | 2018-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684709 | Peoples Community Health Clinic, Inc | Clinic/Center | 425 1/2 East Ridgeway Ave., Waterloo, IA 50702 | 2020-09-23 |
| 1346867439 | Kinza Ali | Family Medicine | 2055 Kimball Avenue, Suite 101, Waterloo, IA 50702 | 2020-07-06 |
| 1073176533 | Sandeep Badyal | Family Medicine | Ne Ia Family Medicine Residency Program, 2055 Kimball Ave. Ste. 101, Waterloo, IA 50702 | 2019-04-19 |
| 1619530763 | Sophia Tariq Qureshi | Family Medicine | Ne Ia Medical Education Foundation, 2055 Kimball Ave. Ste. 101, Waterloo, IA 50702 | 2019-04-15 |
| 1659869915 | Alicia M Johnson | Advanced Practice Midwife | 439 King Street, Waterloo, IA 50702 | 2018-04-23 |
| 1427591411 | Alexandra E. Becker | Specialist/Technologist | 4157 Mourning Dove Drive, Waterloo, IA 50702 | 2016-11-23 |
| 1255793196 | Eastern Iowa Therapeutics PC | Physical Therapist | 1655 E San Marnan Dr, Ste A, Waterloo, IA 50702 | 2016-03-21 |
| 1972859288 | Noble Cedar Psychological Institute | Psychologist | 1425 W. 5th Street, Suite 1, Waterloo, IA 50702 | 2012-07-24 |
| 1417223363 | Rita Marie Menart | Counselor | 2101 Kimball Ave., Suite 138, Waterloo, IA 50702 | 2012-03-26 |
| 1336411685 | Jagpal Singh Suman | Hospitalist | 3421 West 9th Street, Waterloo, IA 50702 | 2012-02-02 |
| Find all providers in zip 50702 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942299243 | Christopher J Considine | Podiatrist | 927 W 4th St, Waterloo, IA 50702-2801 | 2005-10-19 |
| 1982699831 | Stephen Solomon | Podiatrist | 44 Brookeridge Dr, Waterloo, IA 50701-5214 | 2005-09-16 |
| 1770101263 | Aaron Russell Haubrich | Podiatrist | 3421 W 9th St, Waterloo, IA 50702-5401 | 2020-07-10 |
| 1629694682 | Nadia Nikoueiha | Podiatrist | 3421 W 9th St, Waterloo, IA 50702-5401 | 2020-06-24 |
| 1265094239 | Samuel Bernard | Podiatrist | 3421 W 9th St, Waterloo, IA 50702-5401 | 2019-07-01 |
| 1508387028 | Brady Lynn Stewart | Podiatrist | 3421 W 9th St, Waterloo, IA 50702-5401 | 2017-07-06 |
| 1598116014 | Kerwin Dunham | Podiatrist | 3421 W 9th St, Quality Services Dept., Waterloo, IA 50702-5401 | 2016-06-27 |
| 1851702005 | John Whitt | Podiatrist | 927 W 4th St, Waterloo, IA 50702-2801 | 2014-05-09 |
| 1841635745 | Kathie J Whitt | Podiatrist | 927 W 4th St, Waterloo, IA 50702-2801 | 2013-05-06 |
| 1114215415 | Michael A. Murdock | Podiatrist | 44 Brookeridge Dr, Waterloo, IA 50701-5214 | 2011-07-20 |
| Find all providers in WATERLOO | ||||
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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.