Range Podiatric Care, PA

Primary specialty

PodiatristTaxonomy code 213E00000X

License

774 Issued in MN

Legal business name

RANGE PODIATRIC CARE, PA

Practice address

809 N 6TH Ave
Northgate Plaza
Virginia, MN 55792-2308

Phone

(218) 749-3818

Fax

(218) 749-3874

NPI assigned

Apr 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. John Tyler Garner, DPM

Title

Owner

Phone

(218) 744-1961

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319760000000",
    "number": "1194846782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2302 HIGHWAY 53",
            "city": "EVELETH",
            "state": "MN",
            "postal_code": "557348523",
            "telephone_number": "218-744-1961",
            "fax_number": "218-744-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 N 6TH AVE",
            "address_2": "NORTHGATE PLAZA",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557922308",
            "telephone_number": "218-749-3818",
            "fax_number": "218-749-3874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANGE PODIATRIC CARE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2011-10-28",
        "status": "A",
        "authorized_official_last_name": "GARNER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "TYLER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-744-1961",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MN",
            "license": "774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "480000590",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Range Mental Health Center
• Range Mental Health Center Inc (Range Treatment Center)
• Range Mental Health Center Inc (Wellstone Center for Recovery)
• Range Mental Health Center Inc (Detox)
• Range Mental Health Center Inc (Merritt House)
• Recover Health of Minnesota, Inc. (Aveanna Home Health)
• Emily A Reed, APRN,CNP
• Angela Rene Renner, D.C.
• Alissa M Richards
• Kevin P Riess, MD

• Podiatrist in Virginia, MN
• Providers in Virginia, MN by specialty
• Podiatrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.