NPIMap

Organization Active NPI

Associated Foot Surgeons of Southwest Illinois, LTD.

Doing business as Associated Foot Surgeons

  • Foot & Ankle Surgery Podiatrist
  • Belleville, IL
National Provider Identifier
1740653591
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
ASSOCIATED FOOT SURGEONS OF SOUTHWEST ILLINOIS, LTD.
Doing business as
Associated Foot Surgeons
Practice address
2900 Frank Scott Pkwy W
Ste 900
Belleville, IL 62223-5000
Phone
(618) 277-5700
Fax
(618) 257-7049
NPI assigned
Nov 2, 2015
Last updated
Nov 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

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

Authorized official

Name
Mr. Eric C Whittenburg, DPMNPI 1447228481
Title
President
Phone
(618) 277-5700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

2900 Frank Scott Pkwy W
Ste 900
Belleville, IL 62223-5000

Mailing address

2900 Frank Scott Pkwy W
Ste 900
Belleville, IL 62223-5000
Phone (618) 277-5700

Other names 1

  • Associated Foot Surgeons Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160215001709 IL Part B Supplier - Clinic/Group Practice 8123322955 Receives reassigned benefits from 6 practitioners
Practice locations: Belleville, IL; Chester, IL; Columbia, IL; Maryville, IL; O Fallon, IL; Staunton, IL

National Provider Directory

National Provider Directory

Locations

2133 Vadalabene Dr
Ste 5
Maryville, IL 62062
Phone (618) 205-6107

852 Cambridge Blvd
O Fallon, IL 62269
Phone (618) 628-2903

852 Cambridge Blvd
Ste 200
O Fallon, IL 62269
Phone (618) 277-5700

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FIBADD

Practitioners & affiliated clinicians

Practitioners 12

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": "1446422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446422400000",
    "number": "1740653591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 FRANK SCOTT PKWY W",
            "address_2": "STE 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": "STE 900",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622235000",
            "telephone_number": "618-277-5700",
            "fax_number": "618-257-7049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED FOOT SURGEONS OF SOUTHWEST ILLINOIS, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-02",
        "last_updated": "2015-11-02",
        "status": "A",
        "authorized_official_last_name": "WHITTENBURG",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-277-5700",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Associated Foot Surgeons",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.