FAMILY FOOT & ANKLE CLINIC PC (NPI# 1629127741) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629127741 |
| Entity Type | Organization |
| Organization Name | FAMILY FOOT & ANKLE CLINIC PC |
| Practice Address |
1390 N Fairview Ave Decatur IL 62526-3618 |
| Practice Telephone | 2174291512 |
| Practice Fax Number | 2174231465 |
| Mailing Telephone | 2174291512 |
| Mailing Fax Number | 2174231465 |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2011-02-17 |
| Authorized Official Name | DR. STEPHEN KOVACH (PRESIDENT) |
| Authorized Official Telephone | 2174291512 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 060008117 | IL | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 016004985 | 05 | |
| IL | RAILROAD MEDICARE - | CK6281 | 01 |
| IL | 016004984 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033258918 | Family Foot & Ankle Clinic PC | Durable Medical Equipment & Medical Supplies | 525 N 9th St, Bismarck, ND 58501-4510 | 2007-02-06 |
| Street Address |
1390 N FAIRVIEW AVE |
| City | DECATUR |
| State | IL |
| Zip Code | 62526-3618 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679668693 | Terry Reed Custer | Chiropractor | 1390 N Fairview Ave, Decatur, IL 62526-3618 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083100804 | Coalition | Non-emergency Medical Transport (VAN) | 2375 N Longwood Dr, Decatur, IL 62526 | 2018-07-04 |
| 1881116820 | Bria N Howard | Nurse's Aide | 606 E Warren St. Apt 609, Decatur, IL 62526 | 2017-07-12 |
| 1437683679 | Lutheran Child and Family Services | Foster Care Agency | 2826 N. Monroe Street, Decatur, IL 62526 | 2017-04-14 |
| 1083166326 | Whitney Miller | Pharmacist | 225 East Ash Ave, Decatur, IL 62526 | 2016-11-03 |
| 1487053369 | Central Illinois Health Associates, Inc | Preferred Provider Organization | 2300 N. Edward Street, Decatur, IL 62526 | 2014-08-18 |
| 1659787893 | Stephanie Marie Kanitsch | Obstetrics & Gynecology | 544 W Pershing Rd Ste A, Decatur, IL 62526 | 2014-07-09 |
| 1497169973 | Brian Hassinger | Audiologist-Hearing Aid Fitter | 2605 N Water St Ste 101, Decatur, IL 62526 | 2014-06-12 |
| 1891041570 | Decatur 2016 LLC | Dentist | 141 Epershing Rd, Decatur, IL 62526 | 2012-07-31 |
| 1558639005 | Larry Lee Christensen | Pharmacist | 225 Ash Ave, Decatur, IL 62526 | 2011-12-12 |
| 1174821540 | Nathan Pyle | Internal Medicine | 2 Memorial Dr Ste 101, Decatur, IL 62526 | 2011-03-08 |
| Find all providers in zip 62526 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427696392 | Trent Lott | Podiatrist | 3045 Brook Dr, Decatur, GA 30033-3937 | 2019-12-11 |
| 1801352190 | Zachary Adam Rohr | Podiatrist | 2314 Emerald Springs Dr, Decatur, GA 30035-2632 | 2019-02-12 |
| 1083876304 | Greenbriar Foot & Ankle Center LLC | Podiatrist | 4480 Covington Highway, Suite A, Decatur, GA 30034 | 2008-06-27 |
| 1447326442 | Joseph R Dupper | Podiatrist | 2506 Danville Rd Sw Suite 204, Decatur, AL 35603 | 2006-11-28 |
| 1811916497 | Howard M Bryant | Podiatrist | 2575 Snapfinger Rd Ste D, Decatur, GA 30034-2300 | 2006-07-18 |
| 1003846718 | Suzette Andrean Clements | Podiatrist | 4535 Flat Shoals Pkwy, Suite # 301, Decatur, GA 30034-5039 | 2006-07-05 |
| 1538103403 | Jonathan Mark Smith | Podiatrist | 145 S 2nd St, Decatur, IN 46733-1664 | 2006-06-15 |
| 1427014034 | Craig Allen Murad | Podiatrist | 1481 Oakridge Cir, Decatur, GA 30033-2137 | 2006-04-22 |
| 1598230690 | Nickil Nayee | Podiatrist | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2018-10-04 |
| 1417458357 | Karen Moon | Podiatrist | 2701 N Decatur Rd, Decatur, GA 30033-5918 | 2018-02-26 |
| Find all providers in DECATUR | ||||
Please comment or provide details below to improve the information on FAMILY FOOT & ANKLE CLINIC PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.