GVD Podiatry Healthcare PC

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

GVD PODIATRY HEALTHCARE PC

Practice address

1079 South Myrtle Avenue
Kankakee, IL 60901-5457

Phone

(815) 932-8161

NPI assigned

Aug 30, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Grace Victoria David, DPMNPI 1467562561

Title

Ceo President

Phone

(815) 932-8161

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Grace Victoria David, DPM

  • Podiatrist
  • Kankakee, IL
  • NPI 1467562561
  Medicare reassignment NPD Authorized official
• Landon Sessions, CRNA

  • Certified Registered Nurse Anesthetist
  • Portland, OR
  • NPI 1497930432
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023128121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1079 SOUTH MYRTLE AVENUE",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609015457",
            "telephone_number": "815-932-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1079 SOUTH MYRTLE AVENUE",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609015457",
            "telephone_number": "815-932-8161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GVD PODIATRY HEALTHCARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVID",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "VICTORIA",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "815-932-8161",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naga Pushpa Guntupalli, MD
• Anuja Gupta, MD
• Supriya Gupta, MD
• Alicia Guttendorf
• Melanie Guzman, LCSW
• Kyle Hamann, D.O.
• Nicole Hamm-Smith, MS, SSP, NCSP
• Layal Hammad, PHARMD
• Moe-Myint Han, DO
• Kenneth George Handy, MD

• Podiatrist in Kankakee, IL
• Providers in Kankakee, IL by specialty
• Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.