Individual provider Active NPI

Willie Lee Brown, D.P.M.

  • Foot Surgery Podiatrist
  • Belleville, IL
National Provider Identifier
1447392972
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
016.004243 Issued in IL
Practice address
3700 N Belt W
Belleville, IL 62226-5629
Phone
(618) 236-2207
Fax
(618) 236-2377
NPI assigned
Feb 12, 2007
Last updated
Jun 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 2004030548 MO
Foot Surgery Podiatrist 213ES0131X 016.004243 IL Primary

Addresses

Primary practice location

3700 N Belt W
Belleville, IL 62226-5629

Mailing address

PO Box 2682
East Saint Louis, IL 62202-2682
Phone (618) 236-2207

Other practice location 1

2917 Lafayette Ave
Saint Louis, MO 63104-1409
Phone (618) 236-2207

Other identifiers 5

IdentifierTypeStateIssuer
2004030548OtherMOMISSOURI LICENSE NO.
0060101305OtherILBCBS OF ILLINOIS
016.004243OtherILILLINOIS LICENSE NO.
016004243MedicaidIL
303052401MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100421000757 IL Practitioner - Podiatry 9739216839 Practice locations: Belleville, IL
I20100722000205 MO Practitioner - Podiatry 9739216839 Practice locations: Florissant, MO; Bridgeton, MO; Saint Louis, MO

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2917 Lafayette Ave
St. Louis, MO 63104-1409

3700 N Belt W
Belleville, IL 62226-5629
Phone (618) 236-2207

3933 S Broadway
South City Hospital
Saint Louis, MO 63118-4601
Phone (314) 865-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue125
Removal of skin lesions1-10
Removal of nail tissue1562
Removal or shaving of skin growth739
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
016.004243ILMDFoot Surgery Podiatrist

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1447392972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2682",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "622022682",
            "telephone_number": "618-236-2207",
            "fax_number": "618-236-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 N BELT W",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265629",
            "telephone_number": "618-236-2207",
            "fax_number": "618-236-2377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2917 Lafayette Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041409",
            "country_code": "US",
            "telephone_number": "618-236-2207",
            "fax_number": "618-236-2377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "WILLIE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "MO",
            "license": "2004030548",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "IL",
            "license": "016.004243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI LICENSE NO.",
            "identifier": "2004030548",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ILLINOIS",
            "identifier": "0060101305",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS LICENSE NO.",
            "identifier": "016.004243",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016004243",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303052401",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.