GLENWOOD AVENUE FOOT AND ANKLE PLLC (NPI# 1720252026) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720252026 |
| Entity Type | Organization |
| Organization Name | GLENWOOD AVENUE FOOT AND ANKLE PLLC |
| Other Organization Name | BRUCE G FAWCETT DPM |
| Practice Address |
1514 Glenwood Ave Raleigh NC 27608-2368 |
| Practice Telephone | 9198290076 |
| Practice Fax Number | 9198369094 |
| Mailing Telephone | 9198290076 |
| Mailing Fax Number | 9198369094 |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2016-11-04 |
| Authorized Official Name | MR. BRUCE G FAWCETT (SOLE OWNER) |
| Authorized Official Telephone | 9198290076 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
154 | NC | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7908064 | 05 |
| Other Name | Type Code |
|---|---|
| Bruce G Fawcett DPM | Former Legal Business Name - Organization |
| Street Address |
1514 GLENWOOD AVE |
| City | RALEIGH |
| State | NC |
| Zip Code | 27608-2368 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336238336 | Bruce G Fawcett | Podiatrist | 1514 Glenwood Ave, Raleigh, NC 27608-2368 | 2006-10-11 |
| 1487135885 | Instride Foot & Ankle Specialists, Pllc | Podiatrist | 1514 Glenwood Ave, Raleigh, NC 27608-2368 | 2018-08-23 |
| 1235666710 | Capital Foot and Ankle Centers | Podiatrist | 1514 Glenwood Ave, Raleigh, NC 27608-2368 | 2017-05-16 |
| 1588071484 | Eldon Peters | Podiatrist | 1514 Glenwood Ave, Raleigh, NC 27608-2368 | 2014-07-13 |
| 1265611560 | Deep Patel | Podiatrist | 1514 Glenwood Ave, Raleigh, NC 27608-2368 | 2007-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255856175 | Abbe Colodny Pllc | Community/Behavioral Health | 330 Pershing Road, Ralegih, NC 27608 | 2017-08-11 |
| 1417303975 | Restoration Family Counseling | Social Worker | 3103 Eton Rd, Raleigh, NC 27608 | 2016-05-13 |
| 1194192864 | Kathryn Bailey Jeutter | Specialist/Technologist | 1550 Iredell Dr, Raleigh, NC 27608 | 2015-08-28 |
| 1285950345 | Kathryn Dukes Miller | Social Worker | 2306 Mcmullan Circle, Raleigh, NC 27608 | 2010-04-14 |
| 1093043341 | Kristen Bryda Beach | Dietitian, Registered | 608 Scales Towne Court, Raleigh, NC 27608 | 2009-11-25 |
| 1811144942 | Rachael Hollister Wooten | Psychologist | 2721 Kittrell Dr., Raleigh, NC 27608 | 2008-08-20 |
| 1861641862 | Michele Carpenter Bulk | Physical Therapist | 513 E Whitaker Mill Rd, Raleigh, NC 27608 | 2008-09-15 |
| 1770872673 | Wendy Jill Phillips | Physical Therapist | 2626 Glennwood Ave, Suite 160, Raleigh, NC 27608-0000 | 2011-03-31 |
| 1427147875 | Brian J Kelleher Dds Pa | Clinic/Center | 2609 Glenwood Ave, Raleigh, NC 27608-1003 | 2006-10-12 |
| 1942795455 | Seth C Rumley Dds Pa II | Dentist | 2609 Glenwood Ave, Raleigh, NC 27608-1003 | 2018-06-27 |
| Find all providers in zip 27608 | ||||
| Taxonomy Code | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073126223 | King Podiatry and Associates Pllc | Podiatrist | 5116 N Croatan Hwy, Kitty Hawk, NC 27949-3988 | 2020-08-27 |
| 1124475017 | Jeffrey Lynn Hunter | Podiatrist | 367 S Andy Griffith Pkwy # 200, Mount Airy, NC 27030 | 2016-05-20 |
| 1255773222 | Jacob A Panici | Podiatrist | 103 Parkway Office Ct Ste 100, Cary, NC 27518-7429 | 2013-07-19 |
| 1881038453 | Cardinal Podiatry, P.C. | Podiatrist | 1852 Banking St # 9043, Greensboro, NC 27408-7222 | 2013-04-25 |
| 1891007639 | Tori N Simmons Lewis | Podiatrist | 10370 Park Rd Ste 100, Charlotte, NC 28210-8509 | 2010-07-09 |
| 1437316361 | Paul J Keane Dpm | Podiatrist | 506 S Sutherland Ave, Monroe, NC 28112-5061 | 2008-05-19 |
| 1568542181 | Robert Charles Wingate | Podiatrist | 1050 South Peace Haven Road, Winston Salem, NC 27103-9788 | 2006-10-17 |
| 1275630295 | Chukwuma Ukata | Podiatrist | 516 Village Ct, Garner, NC 27529-3600 | 2006-09-20 |
| 1992810717 | Kevin C Mcdonald | Podiatrist | 1022 Lee Ann Dr Ne, Concord, NC 28025-2911 | 2006-08-20 |
| 1568484749 | Jennifer H Purvis | Podiatrist | 3301 Sunset Ave, Rocky Mount, NC 27804-3521 | 2006-07-24 |
| 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.