NPIMap

Organization Active NPI

McLean County Foot & Ankle, LTD.

  • Foot & Ankle Surgery Podiatrist
  • Bloomington, IL
National Provider Identifier
1700273190
Registry record updated Jan 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016005369 Issued in IL
Legal business name
MCLEAN COUNTY FOOT & ANKLE, LTD.
Practice address
3801 Ge Rd Ste 4
Bloomington, IL 61704
Phone
(309) 662-9001
Fax
(309) 662-9005
NPI assigned
Apr 23, 2015
Last updated
Jan 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2019

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

Authorized official

Name
Gerald Paul, DPM
Title
Co-Owner
Phone
(309) 662-9001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 016005369 IL Primary

Addresses

Primary practice location

3801 Ge Rd Ste 4
Bloomington, IL 61704

Mailing address

3801 Ge Rd Ste 4
Bloomington, IL 61704-4193
Phone (309) 662-9001

Other practice location 1

1505 Eastland Dr Ste 250
Bloomington, IL 61701-7906
Phone (309) 662-9001

Other practice location 2

1505 Eastland Dr Ste 250
Bloomington, IL 61701-7906
Phone (309) 662-9001

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11124/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 7

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": "1429747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547164800000",
    "number": "1700273190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 GE RD STE 4",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617044193",
            "telephone_number": "309-662-9001",
            "fax_number": "309-662-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 GE RD STE 4",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "61704",
            "telephone_number": "309-662-9001",
            "fax_number": "309-662-9005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1505 Eastland Dr Ste 250",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IL",
            "postal_code": "617017906",
            "country_code": "US",
            "telephone_number": "309-662-9001",
            "fax_number": "309-662-9005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1505 Eastland Dr Ste 250",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IL",
            "postal_code": "617017906",
            "country_code": "US",
            "telephone_number": "309-662-9001",
            "fax_number": "309-662-9005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MCLEAN COUNTY FOOT & ANKLE, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-23",
        "last_updated": "2019-01-11",
        "status": "A",
        "authorized_official_last_name": "PAUL",
        "authorized_official_first_name": "GERALD",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "309-662-9001",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016005369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2019; 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.