NPIMap

Organization Active NPI

Central Illinois Nerve Testing LTD

  • Primary Podiatric Medicine Podiatrist
  • Peoria, IL
National Provider Identifier
1386802775
Registry record updated Sep 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
016003701 Issued in IL
Legal business name
CENTRAL ILLINOIS NERVE TESTING LTD
Practice address
3322 W Willow Knolls Rd
Peoria, IL 61614-8148
Phone
(309) 691-1727
Fax
(309) 637-2325
NPI assigned
Jun 2, 2008
Last updated
Sep 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2008

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

Authorized official

Name
Dr. John D Ruff, DPMNPI 1366440166
Title
Dr
Phone
(309) 691-1727

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213EP1101X 016003701 IL Primary
Exclusive Provider Organization 302F00000X 016003701 IL

Addresses

Primary practice location

3322 W Willow Knolls Rd
Peoria, IL 61614-8148

Mailing address

614 Spring St
Peoria, IL 61603-4133
Phone (309) 637-3668

Other identifiers 4

IdentifierTypeStateIssuer
1114926748OtherILCURTIS WARD, DPM
1093885378OtherILMARK SMITH, DPM
1083613293OtherILANTHONY V DECEANNE DPM
1285613463OtherILT. KEVIN BRATTAIN, DPM

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221782400000",
    "number": "1386802775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 SPRING ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616034133",
            "telephone_number": "309-637-3668",
            "fax_number": "309-637-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3322 W WILLOW KNOLLS RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148148",
            "telephone_number": "309-691-1727",
            "fax_number": "309-637-2325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL ILLINOIS NERVE TESTING LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-02",
        "last_updated": "2008-09-19",
        "status": "A",
        "authorized_official_last_name": "RUFF",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DR",
        "authorized_official_telephone_number": "309-691-1727",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "IL",
            "license": "016003701",
            "primary": true
        },
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "IL",
            "license": "016003701",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CURTIS WARD, DPM",
            "identifier": "1114926748",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARK SMITH, DPM",
            "identifier": "1093885378",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHONY V DECEANNE DPM",
            "identifier": "1083613293",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "T. KEVIN BRATTAIN, DPM",
            "identifier": "1285613463",
            "state": "IL"
        }
    ],
    "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 Sep 19, 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.