Provider Demographics
NPI:1619145547
Name:REGIONAL FOOT CENTERS PA
Entity Type:Organization
Organization Name:REGIONAL FOOT CENTERS PA
Other - Org Name:THOMAS BEMBYNISTA DPM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT REGIONAL FOOT CENTERS PA
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:F
Authorized Official - Last Name:BEMBYNISTA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:816-461-7755
Mailing Address - Street 1:10550 QUIVIRA RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:OVERLAND PK
Mailing Address - State:KS
Mailing Address - Zip Code:66215
Mailing Address - Country:US
Mailing Address - Phone:816-461-7755
Mailing Address - Fax:816-461-0393
Practice Address - Street 1:10550 QUIVIRA RD
Practice Address - Street 2:SUITE 260
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2306
Practice Address - Country:US
Practice Address - Phone:816-461-7755
Practice Address - Fax:816-461-0393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO484213E00000X
KS196213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A645708AOtherMEDICARE MO
A645708EOtherMEDICARE KS
A645708EOtherMEDICARE KS