Podiatry at Home, LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

PODIATRY AT HOME, LLC

Practice address

5656 Judge Rd
Bettendorf, IA 52722-1211

Phone

(563) 362-8170

Fax

(872) 333-9156

NPI assigned

Jun 17, 2021

Last updated

Jun 17, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

PODIATRY AT HOME, LLCAs reported in NPPES

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

Authorized official

Name

Dr. Andrea Eve Gillio, DPM

Title

Doctor, Owner

Phone

(563) 362-8170

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IA, IL2 enrollments

Enrollment records 2

Part of

Podiatry at Home LLC

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623888000000",
    "number": "1174192801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5656 JUDGE RD",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221211",
            "telephone_number": "563-362-8170",
            "fax_number": "872-333-9156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5656 JUDGE RD",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221211",
            "telephone_number": "563-362-8170",
            "fax_number": "872-333-9156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODIATRY AT HOME, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PODIATRY AT HOME, LLC",
        "enumeration_date": "2021-06-17",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A",
        "authorized_official_last_name": "GILLIO",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "EVE",
        "authorized_official_title_or_position": "DOCTOR, OWNER",
        "authorized_official_telephone_number": "563-362-8170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134338809",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016005330",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Stephen Picchiotti, DC
• Joseph Victor Piersanti Jr., PT
• Mark Pischke, OT
• Planned Parenthood of the Heartland
• Playful Minds Therapeutic Services PLLC
• Joshua T Pogue, DMD
• Katherine A Pohlman, D.C.
• Ryan Travis Pokorney, D.O.
• Christine Poston, PT
• Kathleen Elizabeth Powers, DPT, PCS

• Foot & Ankle Surgery Podiatrist in Bettendorf, IA
• Providers in Bettendorf, IA by specialty
• Foot & Ankle Surgery Podiatrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; 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.