FOOT CARE OF NORTHEAST ARKANSAS PA (NPI# 1750550489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1750550489 |
Entity Type | Organization |
Organization Name | FOOT CARE OF NORTHEAST ARKANSAS PA |
Practice Address |
406 E Washington Ave Jonesboro AR 72401-3108 |
Mailing Address |
Po Box 1984 Jonesboro AR 72403-1984 |
Practice Telephone | 8709338900 |
Practice Fax Number | 8709332611 |
Mailing Telephone | 8709338900 |
Mailing Fax Number | 8709332611 |
Enumeration Date | 2008-02-27 |
Last Update Date | 2008-08-28 |
Authorized Official Name | DR. EDDY LLOYD CALDWELL (PRESIDENT) |
Authorized Official Telephone | 8709338900 |
Authorized Official Credential | DPM |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 213E00000X | Podiatrist | AR163 | AR | Podiatric Medicine & Surgery Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
QUALCHOICE | 16888000000 | 01 | |
AR | MEDICARE | 5F963 | 01 |
AR | 130246748 | 05 | |
AR | 167681748 | 05 | |
BCBS | 5T344 | 01 | |
RR MEDICARE | 480034780 | 01 |
Street Address |
406 E WASHINGTON AVE |
City | JONESBORO |
State | AR |
Zip Code | 72401-3108 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235131640 | Eddy Lloyd Caldwell | Podiatrist | 406 E Washington Ave, Jonesboro, AR 72401-3108 | 2005-08-15 |
1902407349 | Russ Allen Pierce | Pharmacist | 406 E Washington Ave, Jonesboro, AR 72401-3108 | 2020-11-03 |
1982198388 | Anovorx Group, LLC | Pharmacy | 406 E Washington Ave, Jonesboro, AR 72401-3108 | 2018-06-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407453368 | Mariah Kay Jackson | Physical Therapy Assistant | Creative Kids Therapy, Jonesboro, AR 72401 | 2020-10-05 |
1821606005 | Kafayat Folake Iyanda | Specialist/Technologist | 2105 East Aggie Rd, Jonesboro, AR 72401 | 2020-07-14 |
1053936310 | Josh Roberts | Physical Therapist | 1010 South Main St, Jonesboro, AR 72401 | 2020-06-12 |
1003449687 | Amy Mary Elizabeth Daughhetee | Nurse Practitioner | 225 East Washington Ave, Jonesboro, AR 72401 | 2020-02-21 |
1871126698 | Sarah Lowtharp | Clinical Nurse Specialist | 225 East Washington Ave., Jonesboro, AR 72401 | 2020-02-20 |
1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
1265073704 | Michael Bruce Collie | Registered Nurse | 837 Williett Road, Jonesboro, AR 72401 | 2019-10-07 |
1285283432 | Jonesboro Ambulatory Surgery Center, LLC | Clinic/Center | 1710 Mayfield Dr, Jonesboro, AR 72401 | 2019-09-10 |
1841843943 | Destinee Katrina Cole | Specialist/Technologist | 2015 Aggie Rd, Jonesboro, AR 72401 | 2019-07-18 |
1699250472 | Jessica Marie Mcnatt | Occupational Therapist | 907 County Road 753, Jonesboro, AR 72401 | 2018-09-27 |
Find all providers in zip 72401 |
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 |
---|---|---|---|---|
1861436875 | Michael Allen Haughey | Podiatrist | 1416 E Matthews Ave Ste 200, Jonesboro, AR 72401 | 2006-06-16 |
1235131640 | Eddy Lloyd Caldwell | Podiatrist | 406 E Washington Ave, Jonesboro, AR 72401-3108 | 2005-08-15 |
1346246352 | Walter Wadsworth Hayes | Podiatrist | 1000 Windover, Suite A, Jonesboro, AR 72401 | 2005-06-23 |
1215931951 | Lee Paul Woodruff | Podiatrist | 1815 Executive Sq, Jonesboro, AR 72401-6086 | 2005-06-10 |
1114264652 | Jaclyn Marie Schwartz | Podiatrist | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236 | 2013-01-03 |
1255698627 | Vinay Kumar Matai | Podiatrist | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 2012-04-23 |
1184756280 | Christopher Rowlett | Podiatrist | 4802 E Johnson Ave, Jonesboro, AR 72401 | 2007-03-12 |
1376564971 | Mohsen Khoshneviszadeh | Podiatrist | 2400 Mount Zion Pkwy, Southwood Medical Center - Dept of Podiatry, Jonesboro, GA 30236-2500 | 2006-07-21 |
1013940394 | Walter W. Hayes, D.p.m., P.a. | Podiatrist | 1000 Windover, Suite A, Jonesboro, AR 72401 | 2006-07-09 |
1396742870 | Clayton Mobile Diagnostic Clinic | Podiatrist | 6911 Tara Blvd, Jonesboro, GA 30236-1503 | 2005-06-30 |
Find all providers in JONESBORO |
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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.