Tri-State Podiatric Medical Services PSC

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

TRI-STATE PODIATRIC MEDICAL SERVICES PSC

Practice address

411 Letcher St
Henderson, KY 42420-4245

Phone

(270) 830-6522

NPI assigned

Mar 22, 2007

Last updated

Oct 25, 2016By 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

Edward G Anderson, D.P.M.NPI 1366445462

Title

Podiatrist Owner

Phone

(270) 830-5522

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

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.

• Edward Anderson, DPM

  • Podiatrist
  • Henderson, KY
  • NPI 1366445462
  Medicare reassignment Authorized official
• Nicasio Villarreal Jr., KCSA

  • Surgical Assistant
  • Bowling Green, KY
  • NPI 1225188949
  NPD (past)

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477353600000",
    "number": "1750407474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1593",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424191593",
            "telephone_number": "270-830-6522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 LETCHER ST",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424204245",
            "telephone_number": "270-830-6522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE PODIATRIC MEDICAL SERVICES PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2016-10-25",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PODIATRIST OWNER",
        "authorized_official_telephone_number": "270-830-5522",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Traylor, CPHT
• Makaylah B Trent, NP
• Tri-State Comprehensive Care PLLC
• Tri-State Occupational Therapy
• Tri-State Orthopaedic Surgeons, Inc
• Alan Matthew Tripp, D.O.
• Katherine Tsironis
• McKenzie B Tucker, DO
• Ralph Steven Tweddell, LPCC
• Tyler J. Unfried, PA

• Podiatrist in Henderson, KY
• Providers in Henderson, KY by specialty
• Podiatrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.