Active NPI
Daniel P. Congreve, M.D.
- Surgery Physician
- Kewanee, IL
National Provider Identifier
1275760456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 036-059091
- Practice address
- 1051 West South Street
Kewanee, IL 61443 - Phone
- (309) 852-7700
- Fax
- (309) 852-7764
- NPI assigned
- Jun 16, 2009
- Last updated
- Jun 22, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 036-059091 | IL | Primary |
| Surgery Physician | 208600000X | 21926 | IA |
Addresses
Primary practice location
1051 West South Street
Kewanee, IL 61443
Mailing address
P.O. Box 747
1051 West South Street
Kewanee, IL 61443
Phone (309) 852-7700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21926 | IA | MD | Surgery Physician |
| 036-059091 | IL | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genesis Health System | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Genesis Medical Center Dewitt
- Critical Access Hospital
- De Witt, IA
- NPI 1649368523
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245628800000",
"number": "1275760456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 747",
"address_2": "1051 WEST SOUTH STREET",
"city": "KEWANEE",
"state": "IL",
"postal_code": "61443",
"telephone_number": "309-852-7700",
"fax_number": "309-852-7764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1051 WEST SOUTH STREET",
"city": "KEWANEE",
"state": "IL",
"postal_code": "61443",
"telephone_number": "309-852-7700",
"fax_number": "309-852-7764"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONGREVE",
"first_name": "DANIEL",
"middle_name": "P.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-16",
"last_updated": "2009-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": "036-059091",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IA",
"license": "21926",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kewanee, IL
- Sarah Cebula, LCSW
- Charles C Gerleman D C P C
- Loretta A Christiansen
- Breanne Hope Cinnamon, DPT
- City of Kewanee
- Karen Lynn Cooley, DEVELOPMENTAL THERAP
- County of Henry (Henry County Health Department)
- County of Henry
- County of Henry (First Choice Healthcare)
- County of Henry (First Choice Healthcare)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.