MARY C RELLAHAN DPM NPI 1821121120

NPI Information

NPI: 1821121120
Provider Name: MARY C RELLAHAN, DPM
Classification: Podiatrist - 213E00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
2308 GREESIDE COURT
PONTE VEDRA BEACH, FL
ZIP 32082
Phone: (904) 373-0981
Get Directions

Mary C Rellahan, DPM is a podiatrist in Ponte Vedra Beach, FL. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. Mary C Rellahan, DPM NPI is 1821121120. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2308 GREESIDE COURT
PONTE VEDRA BEACH, FL
ZIP 32082-700
Phone: (904) 373-0981
Fax: (904) 373-0981

The NPI 1821121120 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 3/14/2007 and was last updated on 1/23/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213E00000X	Podiatrist		PO2236	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	U28372	MEDICARE UPIN
2	059783000	MEDICAID	FLORIDA
3	480015532	MEDICARE PIN	FLORIDA
4	65224A	MEDICARE PIN	FLORIDA
5	65224Z	MEDICARE PIN	FLORIDA
6	65224	OTHER	FLORIDA	BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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