Bridge City Foot & Ankle LLC (NPI# 1669074316) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider Identifier (NPI) | 1669074316 |
| Entity Type | Organization |
| Organization Name | BRIDGE CITY FOOT & ANKLE LLC |
| Practice Address |
1720 Sw Huntington Ave Portland OR 97225-4752 |
| Practice Telephone | 5038054720 |
| Mailing Address |
1720 Sw Huntington Ave Portland OR 97225-4752 |
| Mailing Telephone | 5038054720 |
| Authorized Official Name | Peter Stach (OWNER/PODIATRIC PHYSICIAN) |
| Authorized Official Telephone | 5038054720 |
| Authorized Official Credential | DPM |
| Organization Subpart | No, this organization is not a Subpart |
| Enumeration Date | 2020-11-09 |
| Last Update Date | 2020-11-09 |
| Primary | Taxonomy | Classification | Taxonomy Group | License Number | State |
|---|---|---|---|---|---|
| Yes | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers |
| 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 |
|---|---|---|---|---|
| 1033560867 | John M Barnes Dpm LLC | Podiatrist | 9615 Nw Randall Ln, Portland, OR 97229-5294 | 2016-06-22 |
| 1619338829 | Cara Beach | Podiatrist | 9900 Sw Hall Blvd Ste 100, Portland, OR 97223-5838 | 2016-03-15 |
| 1265743090 | Nanjin Jasmine Park | Podiatrist | 5311 Sw Baird St, Portland, OR 97219-5023 | 2010-06-26 |
| 1992942064 | Lester Tengsico LLC | Podiatrist | 10424 Se Cherry Blossom Dr Ste F, Portland, OR 97216-2825 | 2009-01-12 |
| 1538339395 | Joseph Michael Mozena | Podiatrist | 2227 Ne Hancock St, Portland, OR 97212-4873 | 2008-03-08 |
| 1245443100 | Daniel L Nusser | Podiatrist | 2809 Ne Broadway, Portland, OR 97232 | 2007-05-08 |
| 1114048667 | Dr John D Mozena Dpm PC | Podiatrist | 8305 Se Monterey Ave Ste 101, Portland, OR 97266-7728 | 2007-04-03 |
| 1124116231 | Ray A Mcclanahan | Podiatrist | 725 Nw 19th Ave, Portland, OR 97209 | 2006-10-11 |
| 1942392113 | John M Barnes | Podiatrist | 506 Ne 49th Ave, Portland, OR 97213-2928 | 2006-09-28 |
| 1427150028 | Christopher S. Seuferling Dpm PC | Podiatrist | 7940 Se Division St, Suite E, Portland, OR 97206-1046 | 2006-09-03 |
| Find all providers in PORTLAND | ||||
| Street Address |
1720 SW HUNTINGTON AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225-4752 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508425034 | Gabrielle Gonzales | Behavior Technician | 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225 | 2019-06-08 |
| 1558844555 | Tate Roseberry | Behavior Technician | 1675 Sw Marlow Avenue, Suite 200, Portland, OR 97225 | 2018-09-14 |
| 1982186300 | Dean Alan Hopkins | Registered Nurse | 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225 | 2018-09-01 |
| 1316449168 | Surgery Center At St. Vincent, LLC | Clinic/Center | 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 | 2018-03-07 |
| 1730606716 | Meghan Louise Lacy | Pediatrics | 11790 Sw Barnes Rd, Blg. A, Suite 140, Portland, OR 97225 | 2017-08-29 |
| 1841733433 | Tia Pugh | Occupational Therapist | 9155 S.w. Barnes Road, East Pavilion, Portland, OR 97225 | 2016-11-30 |
| 1295185585 | Stephanie Lynn Hart | Nurse Practitioner | 9155 Sw Barnes Rd Ste 240, Portland, OR 97225 | 2016-06-16 |
| 1962866244 | Bejian Shamloo | Chiropractor | 10200 Sw Eastridge St., Suite 235, Portland, OR 97225 | 2016-04-12 |
| 1992162630 | Robert Joseph Yoder | Psychologist | 9045 Barnes Rd, Portland, OR 97225 | 2016-01-26 |
| 1316303951 | Katie Herold | Chiropractor | 9315 Sw Morrison St, Portland, OR 97225 | 2016-01-12 |
| Find all providers in zip 97225 | ||||
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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.