Quad Cities Family Foot and Ankle Specialists

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

639 Issued in IA

Legal business name

QUAD CITIES FAMILY FOOT AND ANKLE SPECIALISTS

Practice address

121 W Locust St
#207
Davenport, IA 52803-2827

Phone

(562) 324-2313

Fax

(562) 324-7483

NPI assigned

Jan 30, 2008

Last updated

Feb 14, 2008By 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. Matthew Robert Wilber, DPM

Title

Owner

Phone

(563) 324-2313

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202947200000",
    "number": "1285811471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 W LOCUST ST",
            "address_2": "#207",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032827",
            "telephone_number": "562-324-2313",
            "fax_number": "562-324-7483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 W LOCUST ST",
            "address_2": "#207",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032827",
            "telephone_number": "562-324-2313",
            "fax_number": "562-324-7483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUAD CITIES FAMILY FOOT AND ANKLE SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-30",
        "last_updated": "2008-02-14",
        "status": "A",
        "authorized_official_last_name": "WILBER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "563-324-2313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IA",
            "license": "639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "54815",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0440628",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Davenport, IA
• Providers in Davenport, 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 Feb 14, 2008; 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.