Active NPI
Kim Michael Reichert, DPM
- Foot Surgery Podiatrist
- Belleville, IL
National Provider Identifier
1710955752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot Surgery Podiatrist
- License
- 016003257
- Practice address
- 2900 Frank Scott Pkwy W
Suite 900
Belleville, IL 62223-5000 - Phone
- (618) 277-5700
- Fax
- (618) 257-7049
- NPI assigned
- Mar 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 016-003257 | IL | |
| Foot Surgery Podiatrist | 213ES0131X | 016003257 | IL | Primary |
Addresses
Primary practice location
2900 Frank Scott Pkwy W
Suite 900
Belleville, IL 62223-5000
Mailing address
2900 Frank Scott Pkwy W
Suite 900
Belleville, IL 62223-5000
Phone (618) 277-5700
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| STL2750010 | Other | UHC | |
| 102179 | Other | IL | HEALTHLINK |
| 4134729 | Other | IL | AETNA |
| 601-15944 | Other | IL | BC/BS |
| 480026528 | Other | IL | RAILROAD MEDICARE PTAN |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016-003257 | IL | MD | Foot & Ankle Surgery Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335225600000",
"number": "1710955752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2900 FRANK SCOTT PKWY W",
"address_2": "SUITE 900",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622235000",
"telephone_number": "618-277-5700",
"fax_number": "618-257-7049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 FRANK SCOTT PKWY W",
"address_2": "SUITE 900",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622235000",
"telephone_number": "618-277-5700",
"fax_number": "618-257-7049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REICHERT",
"first_name": "KIM",
"middle_name": "MICHAEL",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-08",
"last_updated": "2012-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "IL",
"license": "016-003257",
"primary": false
},
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "IL",
"license": "016003257",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "STL2750010",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "102179",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4134729",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "601-15944",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE PTAN",
"identifier": "480026528",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Belleville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.