NPIMap

Organization Active NPI

David Kindred Integrated Medicine PC

  • Public Health & General Preventive Medicine Physician
  • Peoria, IL
National Provider Identifier
1164761268
Registry record updated Feb 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
036086752 Issued in IL
Legal business name
DAVID KINDRED INTEGRATED MEDICINE PC
Practice address
2806 N Knoxville Ave
Peoria, IL 61604-2870
Phone
(309) 214-9950
NPI assigned
Feb 8, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2013

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

Authorized official

Name
David Kindred, M.D.
Title
Owner
Phone
(309) 214-9950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2083P0901X 036086752 IL Primary

Addresses

Primary practice location

2806 N Knoxville Ave
Peoria, IL 61604-2870

Mailing address

2806 N Knoxville Ave
Peoria, IL 61604-2870
Phone (309) 214-9950

National Provider Directory

National Provider Directory
Tax ID family
David Kindred Integerated Medicine PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1360281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360281600000",
    "number": "1164761268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2806 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616042870",
            "telephone_number": "309-214-9950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2806 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616042870",
            "telephone_number": "309-214-9950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID KINDRED INTEGRATED MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-08",
        "last_updated": "2013-02-08",
        "status": "A",
        "authorized_official_last_name": "KINDRED",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-214-9950",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "IL",
            "license": "036086752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.