NICHOLAS P COSTIDAKIS (NPI# 1972571297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972571297 |
| Entity Type | Individual |
| Full Name | NICHOLAS P COSTIDAKIS |
| Credential | DPM |
| Practice Address |
2606 Veterans Memorial Pkwy S Ste 8 Lafayette IN 47909-9192 |
| Mailing Address |
Po Box 4699 Lafayette IN 47903-4699 |
| Practice Telephone | 7654474776 |
| Practice Fax Number | 7654474809 |
| Mailing Telephone | 7654492732 |
| Mailing Fax Number | 7654491196 |
| Enumeration Date | 2006-03-11 |
| Last Update Date | 2020-06-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 07000748A | IN | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | CAQH | 10781139 | 01 |
| IN | MEDICARE RAILROAD NUMBER | 480034530 | 01 |
| IN | ANTHEM PROVIDER NUMBER | 000000247376 | 01 |
| IN | 100232960 | 05 |
| Street Address |
2606 VETERANS MEMORIAL PKWY S STE 8 |
| City | LAFAYETTE |
| State | IN |
| Zip Code | 47909-9192 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790963197 | Unity Healthcare, LLC | Podiatrist | 2606 Veterans Memorial Pkwy S Ste 8, Lafayette, IN 47909-9192 | 2008-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285135244 | Glasswater Creek of Lafayette, LLC | Assisted Living Facility | 208 Beck Ln, Lafayette, IN 47909 | 2018-02-26 |
| 1518418680 | Dental Professionals of Indiana, PC | Dentist | 2000 Veterans Memorial Parkway S, Lafayette, IN 47909 | 2016-10-24 |
| 1013394709 | Todd Hardin | Dentist | 2 Walter Scholer Drive, Lafayette, IN 47909 | 2015-05-01 |
| 1801296967 | Lacey Hintz | Occupational Therapy Assistant | 2308 Edgelea Dr, Lafayette, IN 47909 | 2014-08-26 |
| 1457691180 | Alicia A Duncan | Lactation Consultant, Non-RN | 207 Buckingham Drive, Lafayette, IN 47909 | 2013-02-16 |
| 1558646505 | Tammie Anne Shockley | Pharmacist | 2800 Old Us 231 S, Walgreens 10974, Lafayette, IN 47909 | 2011-10-20 |
| 1952553448 | Regina R Pilotte | Occupational Therapist | 3864 East 500 South, Lafayette, IN 47909 | 2008-10-16 |
| 1811182405 | Assisted Living Concepts Inc | Assisted Living Facility | 167 West 240 South, Lafayette, IN 47909 | 2007-09-07 |
| 1073716585 | Julia Ann Dillon | Counselor | 3554 Promenade Pkwy Ste E, Lafayette, IN 47909 | 2007-06-11 |
| 1639291503 | Winifred A. Landis | Pharmacist | 2806 Us 231 South, Lafayette, IN 47909 | 2007-04-04 |
| Find all providers in zip 47909 | ||||
| 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 |
|---|---|---|---|---|
| 1952812455 | Maraist Foot and Ankle Center LLC | Podiatrist | 155 Hospital Dr Ste 203, Lafayette, LA 70503-2852 | 2017-10-24 |
| 1013357714 | Katherine Cummins | Podiatrist | 1345 Unity Pl Ste 225, Lafayette, IN 47905-5762 | 2013-06-27 |
| 1548493067 | Unity Healthcare, LLC | Podiatrist | 750 Park East Blvd, Unit 4, Lafayette, IN 47905 | 2009-09-01 |
| 1174601264 | Michael W. Colburn | Podiatrist | 911 Moraga Rd Ste 101, Lafayette, CA 94549-4591 | 2006-11-02 |
| 1326130121 | Verne Lawrence Thibodeaux | Podiatrist | 1602 W Pinhook, Suite 100, Lafayette, LA 70508 | 2006-09-29 |
| 1700992187 | Ben A Vierra | Podiatrist | 601 West St Mary Blvd, Ste 106, Lafayette, LA 70506 | 2006-08-21 |
| 1821056128 | Scott Mitchell Beairsto | Podiatrist | 205 Bonaire Dr, Lafayette, LA 70506-6827 | 2006-05-03 |
| 1659378453 | George A Sobiesk | Podiatrist | 4809 Ambassador Caffery Pkwy, Suite 200, Lafayette, LA 70508-6917 | 2005-07-07 |
| 1790963197 | Unity Healthcare, LLC | Podiatrist | 2606 Veterans Memorial Pkwy S Ste 8, Lafayette, IN 47909-9192 | 2008-02-07 |
| 1578748554 | Unity Healthcare, LLC | Podiatrist | 2020 Union St, Suite 100, Lafayette, IN 47904-3432 | 2008-01-08 |
| Find all providers in LAFAYETTE | ||||
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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.