DR. THOMAS RICHARD NYSTROM (NPI# 1750477493) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750477493 |
| Entity Type | Individual |
| Full Name | DR. THOMAS RICHARD NYSTROM |
| Credential | DPM |
| Practice Address |
80 East Main St Canton NY 13617 |
| Practice Telephone | 3153868121 |
| Practice Fax Number | 3153868121 |
| Mailing Telephone | 3153868121 |
| Mailing Fax Number | 3153868121 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | N2966 | NY | Podiatric Medicine & Surgery Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487040762 | Thomas Allen Nystrom | Registered Nurse | 167 North Main Street, Tuba City, AZ 86045-0600 | 2015-04-13 |
| Street Address |
80 EAST MAIN ST |
| City | CANTON |
| State | NY |
| Zip Code | 13617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578850558 | Ann Elizabeth Petroccione | Registered Nurse | 80 East Main St, Canton Pediatrics, Canton, NY 13617 | 2011-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700428802 | Meagan Elizabeth Hogan | Physician Assistant | 6119 Us Highway Route 11, Canton, NY 13617 | 2019-10-10 |
| 1982251740 | Wilma J. Blackmer | Technician | 1756 Cr 14, Canton, NY 13617 | 2019-08-26 |
| 1326525270 | Kylie Broughal | Physician Assistant | 6119 St Hwy Rt 11, St Lawrence Medical Office Complex, Canton, NY 13617 | 2018-07-24 |
| 1891299608 | Sheena Teresa Smith | Counselor | 310 State Highway 310, Suite 1, Canton, NY 13617 | 2018-03-19 |
| 1972024594 | Patrick James Sullivan | Physician Assistant | 6619 State Highway Route 11, Canton, NY 13617 | 2017-07-05 |
| 1225482763 | Howard Orthotics and Prosthetics, LLC | Prosthetic/Orthotic Supplier | 6128 Us Highway11, Canton, NY 13617 | 2016-04-21 |
| 1831534452 | Chin Hung Ho | Dermatology | 6119 State Highway Rt 11, Cph Dermotology, Canton, NY 13617 | 2013-05-09 |
| 1194061663 | Sarah Prairie | Counselor | 80 State Hwy 310, Suite 1, Canton, NY 13617 | 2013-01-02 |
| 1679859094 | Nathan Ellis | Occupational Therapist | 139 Outer State St. Rd, Canton, NY 13617 | 2011-10-31 |
| 1407139017 | Julianne Rutley | Occupational Therapist | 139 Outer State Street Rd, Canton, NY 13617 | 2011-09-21 |
| Find all providers in zip 13617 | ||||
| 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 |
|---|---|---|---|---|
| 1053887869 | Canton Podiatry Pllc | Podiatrist | 42017 Ford Rd, Canton, MI 48187-3669 | 2018-10-18 |
| 1083008221 | Donald A Leright Dpm Pllc | Podiatrist | 46036 Michigan Ave, Suite 286, Canton, MI 48188-2304 | 2015-03-25 |
| 1023458304 | Evan Michael Lewis | Podiatrist | 147 Reinhardt College Pkwy Ste 10, Canton, GA 30114-5295 | 2013-07-01 |
| 1881858959 | Connecticut Foot Specialists PC | Podiatrist | 259 Albany Turnpike, Suite C, Canton, CT 06019 | 2008-07-17 |
| 1457562175 | Janay L Harper Dpm Pllc | Podiatrist | 156 River Oaks Dr Ste B, Canton, MS 39046-5376 | 2007-05-24 |
| 1790868826 | Hon W Fong Dpm Pllc | Podiatrist | 2050 N Haggerty Rd Ste 120, Canton, MI 48187-3796 | 2006-10-23 |
| 1871675009 | George Madson Kemper Jr. | Podiatrist | 5454 Fulton Dr Nw, Canton, OH 44718-1727 | 2006-10-19 |
| 1215027420 | Robert I Lubin | Podiatrist | 8552 N Canton Center Rd, Canton, MI 48187-1310 | 2006-10-16 |
| 1982795365 | Canton Podaitry Associates | Podiatrist | 742 Washington St, Canton, MA 02021-3039 | 2006-09-28 |
| 1558387423 | Scott M Aronson | Podiatrist | 1017 Turnpike St Ste 12b, Canton, MA 02021-2847 | 2006-07-14 |
| Find all providers in CANTON | ||||
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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.