NPIMap

Organization Active NPI

Footworld Medical Center

  • Podiatric Clinic/Center
  • Peoria, IL
National Provider Identifier
1316532906
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
Legal business name
FOOTWORLD MEDICAL CENTER
Practice address
409 N Western Ave
Peoria, IL 61606-1652
Phone
(309) 676-3668
NPI assigned
Mar 4, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Authorized official

Name
Dr. Ernest NwaniNPI 1679620876
Title
Ceo
Phone
(309) 676-3668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X Primary

Addresses

Primary practice location

409 N Western Ave
Peoria, IL 61606-1652

Mailing address

409 N Western Ave
Peoria, IL 61606-1652
Phone (309) 676-3668

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614816000000",
    "number": "1316532906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 N WESTERN AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616061652",
            "telephone_number": "309-676-3668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 N WESTERN AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616061652",
            "telephone_number": "309-676-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTWORLD MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A",
        "authorized_official_last_name": "NWANI",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "309-676-3668",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; 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.