Provider Demographics
NPI:1760660096
Name:ANTOINETTE D. ADAMS, DPM, PC
Entity Type:Organization
Organization Name:ANTOINETTE D. ADAMS, DPM, PC
Other - Org Name:ADAMS COMPREHENSIVE FOOT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTOINETTE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:434-336-9001
Mailing Address - Street 1:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:VA
Mailing Address - Zip Code:23847-0306
Mailing Address - Country:US
Mailing Address - Phone:434-336-9001
Mailing Address - Fax:434-336-9229
Practice Address - Street 1:137 BAKER ST
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:VA
Practice Address - Zip Code:23847-1703
Practice Address - Country:US
Practice Address - Phone:434-336-9001
Practice Address - Fax:434-336-9229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103300897213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010008221Medicaid
VA146796OtherANTHEM
VA3724957OtherCIGNA
VA33691OtherOPTIMA
VA=========OtherHUMANA
VA146796OtherANTHEM
VA=========OtherTRICARE
VA190000788Medicare PIN
VA=========OtherVIRGINIA PREMIER
VA33691OtherOPTIMA