NPIMap

Individual provider Active NPI

David S Footerman, MD

  • Pain Medicine (Anesthesiology) Physician
  • Rockford, IL
National Provider Identifier
1629023817
Registry record updated Jun 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
036-083677 Issued in IL
Practice address
6090 Strathmoor Dr
Rockford, IL 61107-6628
Phone
(815) 633-8586
NPI assigned
May 24, 2006
Last updated
Jun 6, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036083677 IL
Pain Medicine (Anesthesiology) Physician 207LP2900X 036-083677 IL Primary

Addresses

Primary practice location

6090 Strathmoor Dr
Rockford, IL 61107-6628

Mailing address

6785 Weaver Rd
Ste D
Rockford, IL 61114-8055
Phone (815) 633-8586

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
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.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-083677ILMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McHenry Medical Center SC Past Accepting new patients
Rockford Retina Clinic, S.C. Past Accepting new patients
Superiorhealth & Wellness of McHenry LTD Past Accepting new patients
Interventional Pain Management, LTD. Anesthesiology Past Accepting new patients
Stat Anesthesia Specialists, LTD. Anesthesiology Past Accepting new patients

Organizations & group practices 6

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307318400000",
    "number": "1629023817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6785 WEAVER RD",
            "address_2": "STE D",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611148055",
            "telephone_number": "815-633-8586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6090 STRATHMOOR DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076628",
            "telephone_number": "815-633-8586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOOTERMAN",
        "first_name": "DAVID",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2011-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036083677",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036-083677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; 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.