Buckeye Foot Care

Primary specialty

PodiatristTaxonomy code 213E00000X

License

36002841 Issued in OH

Legal business name

BUCKEYE FOOT CARE

Practice address

14401 Snow Rd Ste 102
Brook Park, OH 44142-2583

Phone

(216) 267-0304

NPI assigned

Nov 2, 2006

Last updated

Feb 5, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Howard Myles Kimmel, DPMNPI 1124055918

Title

Doctor of Podiatry

Phone

(216) 267-0304

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OH2 enrollments

Enrollment records 2

Tax ID family

Buckeye Foot Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Buckeye Foot Care

  • Podiatrist
  • Willoughby, OH
  • NPI 1275159345
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Howard Myles Kimmel, DPM

  • Podiatrist
  • Brookpark, OH
  • NPI 1124055918
  Medicare reassignment NPD Authorized official
• Nancy A Domanowski, DPM

  • Podiatrist
  • Brookpark, OH
  • NPI 1366523276
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1093893380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14401 SNOW RD STE 102",
            "city": "BROOK PARK",
            "state": "OH",
            "postal_code": "441422583",
            "telephone_number": "216-267-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14401 SNOW RD STE 102",
            "city": "BROOK PARK",
            "state": "OH",
            "postal_code": "441422583",
            "telephone_number": "216-267-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKEYE FOOT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "KIMMEL",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "MYLES",
        "authorized_official_title_or_position": "DOCTOR OF PODIATRY",
        "authorized_official_telephone_number": "216-267-0304",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36002841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2733742",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480026423",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG0721",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madonna Bowen, RN
• Eric Branham
• Brook Park Functional Rehab
• Brookpark City
• Lauren Zellmer Brown, PSY.D.
• Yazmin Calderon Lopez
• Erica Callahan
• Laurie Ann Campbell, PEER SPECIALIST
• Shareece Cannonier, PSY AIT MA
• Terese L Carosella

• Podiatrist in Brookpark, OH
• Providers in Brookpark, OH by specialty
• Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.