Midwest Podiatry Group, PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

016003172 Issued in IL

Legal business name

MIDWEST PODIATRY GROUP, PC

Practice address

3827 N Prospect Rd
Peoria, IL 61616-7767

Phone

(309) 686-1000

NPI assigned

Aug 23, 2006

Last updated

Mar 17, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Donald Joe Sheller, DPMNPI 1942270434

Title

President

Phone

(309) 686-1000

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19358/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Donald Joe Sheller, DPM

  • Foot & Ankle Surgery Podiatrist
  • Peoria, IL
  • NPI 1942270434
  Medicare reassignment Care Compare group NPD Authorized official
• Christine Celeste Kancius, DPM

  • Podiatrist
  • Morton, IL
  • NPI 1013928365
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268784000000",
    "number": "1184731663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3827 N PROSPECT RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616167767",
            "telephone_number": "309-686-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3827 N PROSPECT RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616167767",
            "telephone_number": "309-686-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST PODIATRY GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2010-03-17",
        "status": "A",
        "authorized_official_last_name": "SHELLER",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "JOE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-686-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016003172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA0891",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016003172",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Midwest Hearing Center
• Midwest Multicare, PC
• Midwest Orthodontic Associates
• Midwest Orthopaedic Center S C
• Midwest Pain & Spine Center, LLC
• Midwest Reproductive Care LLC (Reproductive Health and Fertility Center)
• Midwest Urological Group, LTD.
• Midwest Urological Group, LTD.
• Jeffrey Benjamin Miessau, PA-C
• Keely Renee Mihavics, PHARMD

• Foot & Ankle Surgery Podiatrist in Peoria, IL
• Providers in Peoria, IL by specialty
• Foot & Ankle Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2010; 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.