Organization Active NPI

Alton Podiatry Clinic, P.C.

  • Foot & Ankle Surgery Podiatrist
  • Alton, IL
National Provider Identifier
1780707950
Registry record updated Nov 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016004028 Issued in IL
Legal business name
ALTON PODIATRY CLINIC, P.C.
Practice address
3535 College Ave
Alton, IL 62002-5009
Phone
(618) 462-2316
Fax
(618) 462-0954
NPI assigned
Apr 10, 2007
Last updated
Nov 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2008

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

Authorized official

Name
Dr. Lawrence Anthony Huels, D.P.M.NPI 1891978102
Title
President
Phone
(618) 462-2316

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 Podiatrist 213ES0103X 016004028 IL Primary

Addresses

Primary practice location

3535 College Ave
Alton, IL 62002-5009

Mailing address

3535 College Ave
Alton, IL 62002-5009
Phone (618) 462-2316

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130313000316 IL Part B Supplier - Clinic/Group Practice 9739395252 Receives reassigned benefits from 2 practitioners
Practice locations: Alton, IL

National Provider Directory

National Provider Directory

Locations

3535 College Ave
Alton, IL 62002
Phone (618) 462-2316

Practitioners & affiliated clinicians

Practitioners 2

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": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226361600000",
    "number": "1780707950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 COLLEGE AVE",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620025009",
            "telephone_number": "618-462-2316",
            "fax_number": "618-462-0954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 COLLEGE AVE",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620025009",
            "telephone_number": "618-462-2316",
            "fax_number": "618-462-0954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTON PODIATRY CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2008-11-11",
        "status": "A",
        "authorized_official_last_name": "HUELS",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-462-2316",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016004028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2008; 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.