John Barrett, D.P.M.
Individual provider Active NPI Podiatrist · Boardman, OH
NPI 1154328557 · NPPES record last updated Feb 21, 2019
Key facts
- NPI
- 1154328557
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Podiatrist 213E00000X
- License
- 36-00 2403 (OH)
- Practice address
- 1265 Boardman Canfield Rd
Boardman, OH 44512-4004 - Phone
- (330) 758-8808
- Fax
- (330) 758-4288
- NPI assigned
- Jun 30, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36-00 2403 | OH | MD | Podiatrist |
| SC-00-4452 | PA | MD | Podiatrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | SC-00-4452 | PA | |
| Podiatrist | 213E00000X | 36-00 2403 | OH | Yes |
Addresses
Primary practice location
1265 Boardman Canfield Rd
Boardman, OH 44512-4004
Mailing address
PO Box 378
Sandusky, OH 44871-0378
Phone (419) 626-6161
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0664393 | Medicaid | OH | |
| 2101013-000 | Medicaid | WV |
Other providers in Boardman, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.