Individual provider Active NPI

Edgar Alexander Barrios, PEDORTHIST

  • Pedorthist
  • Spring Valley, IL
National Provider Identifier
1386139145
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PedorthistTaxonomy code 224L00000X
License
212000132 Issued in IL
Practice address
307 W Saint Paul St
Spring Valley, IL 61362-1860
Phone
(312) 315-6584
NPI assigned
Jun 25, 2018
Last updated
Jun 25, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pedorthist 224L00000X 212000132 IL Primary

Addresses

Primary practice location

307 W Saint Paul St
Spring Valley, IL 61362-1860

Mailing address

702 Justina St
Hinsdale, IL 60521-2425
Phone (312) 315-6584

Other identifiers 1

IdentifierTypeStateIssuer
212000132OtherILILLINOIS LICENSE

Other names 1

  • Mr. Alex Barrios Professional name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
212000132ILMDPedorthist

Practice roles

OrganizationSpecialtyStatusNew patients
Animate Pedorthics Orthotics & Prosthetics LLC Pedorthist Current Accepting new patients
Animate Pedorthics Orthotics Prosthetics 4U Inc Current Accepting new patients
Perfect Fit Footwear Current Accepting new patients
Pack Machine Incorporated Past Accepting new patients

Locations

307 W Saint Paul St
Spring Valley, IL 61362
Phone (312) 315-6584

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1386139145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 JUSTINA ST",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605212425",
            "telephone_number": "312-315-6584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 W SAINT PAUL ST",
            "city": "SPRING VALLEY",
            "state": "IL",
            "postal_code": "613621860",
            "telephone_number": "312-315-6584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRIOS",
        "first_name": "EDGAR",
        "middle_name": "ALEXANDER",
        "name_prefix": "Mr.",
        "credential": "PEDORTHIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-25",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224L00000X",
            "taxonomy_group": "",
            "desc": "Pedorthist",
            "state": "IL",
            "license": "212000132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS LICENSE",
            "identifier": "212000132",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEX",
            "last_name": "BARRIOS",
            "prefix": "MR.",
            "credential": "PEDORTHIST",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Spring Valley, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; 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.