DR. BRENT CHRISTOPHER RICKS (NPI# 1821309295) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1821309295 |
Entity Type | Individual |
Full Name | DR. BRENT CHRISTOPHER RICKS |
Credential | DPM |
Practice Address |
1601 Mchenry Village Way Ste 3 Modesto CA 95350-4338 |
Practice Telephone | 2093802884 |
Practice Fax Number | 2095263908 |
Mailing Telephone | 2093802884 |
Mailing Fax Number | 2095263908 |
Enumeration Date | 2010-06-30 |
Last Update Date | 2013-07-09 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
E 5055 | CA | Podiatric Medicine & Surgery Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | MEDICARE PTAN | HH008A | 01 |
Street Address |
1601 MCHENRY VILLAGE WAY STE 3 |
City | MODESTO |
State | CA |
Zip Code | 95350-4338 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548291263 | Marvin Daryle Ricks | Podiatrist | 1601 Mchenry Village Way Ste 3, Modesto, CA 95350-4338 | 2006-07-05 |
1457749939 | Brent Ricks Dpm | Podiatrist | 1601 Mchenry Village Way Ste 3, Modesto, CA 95350-4338 | 2015-01-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164020459 | Karina Montes Rodriguez | Case Manager/Care Coordinator | Cip 1540 Florida Ave, Suite 212, Modesto, CA 95350 | 2020-10-09 |
1134737315 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 2057 Tully Road, Suite A, Modesto, CA 95350 | 2020-07-14 |
1588211254 | Karla Junuen Toscano | Licensed Vocational Nurse | 1235 Mchenry Ave. Suites A&b, Modesto, CA 95350 | 2019-08-19 |
1831694769 | Loretta Myers-weber | Nurse Practitioner | 1510 Florida Ave Ste A, Modesto, CA 95350 | 2018-03-23 |
1720599632 | Coral Alejandra Amador | Counselor | 1700 Mchenry Village Way, Suite 11b, Modesto, CA 95350 | 2017-10-18 |
1053820522 | Pannu and Henne Dental Corp. | Dentist | 3219 Mc Henry Ave, Suite E, Modesto, CA 95350 | 2017-09-27 |
1346779709 | Kevin Sotelo | Behavior Technician | 2630 W Rumble Road, Modesto, CA 95350 | 2017-06-08 |
1255869566 | Hoa Xuan Phan | Family Medicine | 1441 Florida Ave Ste 200, Modesto, CA 95350 | 2017-05-31 |
1356881163 | Brady S Marshall | Dentist | 201 E. Orangeburg Avenue, Suite C, Modesto, CA 95350 | 2017-02-27 |
1750755476 | Caremore Health Plan | Nurse Practitioner | 1234 Mchenry Avenue, Modesto, CA 95350 | 2015-11-18 |
Find all providers in zip 95350 |
Taxonomy Code | 213ES0103X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
Specialization | Foot & Ankle Surgery |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861912438 | Michael Medhat Daniel | Podiatrist | 1213 Coffee Rd Ste A, Modesto, CA 95355-4229 | 2017-06-23 |
1669797668 | Christian Rand Tolboe | Podiatrist | 1401 Spanos Ct Ste 104, Modesto, CA 95355-2811 | 2010-04-01 |
1720041957 | David I Wells | Podiatrist | 1541 Florida Ave Ste 103, Modesto, CA 95350-4438 | 2006-04-10 |
1124020102 | H Rand Tolboe | Podiatrist | 1401 Spanos Ct, Suite 104, Modesto, CA 95355-2810 | 2005-08-10 |
1255871125 | Tolboe Foot & Ankle, Inc., A Podiatric Medical Corporation | Podiatrist | 1401 Spanos Court, Suite #104, Modesto, CA 95355-2811 | 2017-02-27 |
1689057572 | David Paxton | Podiatrist | 1401 Spanos Ct Ste 104, Modesto, CA 95355 | 2015-07-09 |
1457749939 | Brent Ricks Dpm | Podiatrist | 1601 Mchenry Village Way Ste 3, Modesto, CA 95350-4338 | 2015-01-06 |
1184047813 | H. Rand Tolboe, D.p.m. | Podiatrist | 1401 Spanos Ct, Suite 104, Modesto, CA 95355-2810 | 2014-01-31 |
1790034320 | Crystal Sheng-shan Hsu | Podiatrist | 1510 Florida Ave, Modesto, CA 95350-4437 | 2012-08-29 |
1336311760 | Rajdeep K Sahota | Podiatrist | 2116 E Orangeburg Ave, Suite A, Modesto, CA 95355-3370 | 2008-03-26 |
Find all providers in MODESTO |
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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.