NPIMap

Organization Active NPI

Kevin C. Dodson D.P.M.

  • Prosthetic/Orthotic Supplier
  • East Moline, IL
National Provider Identifier
1699056044
Registry record updated Aug 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
016004304 Issued in IL
Legal business name
KEVIN C. DODSON D.P.M.
Practice address
1620 9TH St
East Moline, IL 61244-2120
Phone
(309) 755-3809
Fax
(309) 755-3860
NPI assigned
Aug 30, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2011

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

Authorized official

Name
Dr. Kevin C. Dodson, D.P.M.NPI 1629076559
Title
Owner
Phone
(309) 755-3809

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 016004304 IL Primary

Addresses

Primary practice location

1620 9TH St
East Moline, IL 61244-2120

Mailing address

1620 9TH St
East Moline, IL 61244-2120
Phone (309) 755-3809

National Provider Directory

National Provider Directory
Tax ID family
Kevin C Dodson DPM2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the 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, 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": "1314662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314662400000",
    "number": "1699056044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 9TH ST",
            "city": "EAST MOLINE",
            "state": "IL",
            "postal_code": "612442120",
            "telephone_number": "309-755-3809",
            "fax_number": "309-755-3860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 9TH ST",
            "city": "EAST MOLINE",
            "state": "IL",
            "postal_code": "612442120",
            "telephone_number": "309-755-3809",
            "fax_number": "309-755-3860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN C. DODSON D.P.M.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-30",
        "last_updated": "2011-08-30",
        "status": "A",
        "authorized_official_last_name": "DODSON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-755-3809",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "IL",
            "license": "016004304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.