Individual provider Active NPI

Douglas John Freel, DPM

  • Foot Surgery Podiatrist
  • Quincy, IL
National Provider Identifier
1184614653
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
016-003720 Issued in IL
Practice address
1118 Hampshire St
Quincy, IL 62301-3027
Phone
(217) 222-6550
NPI assigned
Oct 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 000712 MO
Foot Surgery Podiatrist 213ES0131X 016-003720 IL Primary

Addresses

Primary practice location

1118 Hampshire St
Quincy, IL 62301-3027

Mailing address

5012 Starboard Dr
Quincy, IL 62305-8280
Phone (217) 316-1260

Other identifiers 5

IdentifierTypeStateIssuer
009464OtherHEALTH ALLIANCE
3074226001OtherCIGNA
1184614653MedicaidMO
00132005OtherILBLUE CROSS/BLUE SHIELD
127214OtherHEALTHLINK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20071227000278 MO Practitioner - Podiatry 3476633769 Reassigns benefits to 1 organization
I20100810000649 IL Practitioner - Podiatry 3476633769

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016-003720ILMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pike County Memorial Hospital Current Accepting new patients
Pike County Memorial Hospital CurrentSince Aug 15, 2018 Accepting new patients
Pike County Memorial Hospital CurrentSince Aug 15, 2018 Accepting new patients
Midwest Foot and Ankle Specialists PC Foot Surgery PastSince Mar 25, 1995 Accepting new patients

Locations

2305 Georgia St
Louisiana, MO 63353
Phone (573) 754-4584

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1184614653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5012 STARBOARD DR",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623058280",
            "telephone_number": "217-316-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 HAMPSHIRE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623013027",
            "telephone_number": "217-222-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEL",
        "first_name": "DOUGLAS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "MO",
            "license": "000712",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "IL",
            "license": "016-003720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "009464",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3074226001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184614653",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "00132005",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "127214",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.