Progressive Podiatry
LBN: Bryan Fallis
Progressive Podiatry is an health care organization with primary practice located at 2300 Chamber Center Dr Suite 100, Lakeside Park KY 41017-1673. The organization recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Suppliers / Durable Medical Equipment & Medical Supplies. Suppliers / Durable Medical Equipment & Medical Supplies is the primary health care specialty.
Bryan Fallis can be contacted via phone (859) 331-2440, or through Fallis, Bryan V via phone (859) 331-2440.
Contact Information
Primary practice address
2300 Chamber Center Dr Suite 100
Lakeside Park KY 41017-1673
Phone: (859) 331-2440
Fax: (859) 331-2449
Website:
Authorized official contact:
Name: Fallis, Bryan V Doctor of Podiatric Medicine (DPM)
Phone: (859) 331-2440
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 00258 | Kentucky |
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X |
Profile Details
| NPI number | 1720314966 |
|---|---|
| LBN Legal business name | Bryan Fallis |
| DBA Doing business as | Progressive Podiatry |
| Authorized official | Fallis, Bryan V Doctor of Podiatric Medicine (DPM) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 22nd, 2009 |
| Last updated | Jan 29th, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720314966 | NPPES |
| Kentucky | MEDICAID | 7100096290 | |
| Kentucky | MEDICAID | 80000151 |
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