Individual provider Active NPI

Alan Richard Gitersonke, DPM

  • Podiatrist
  • Granite City, IL
National Provider Identifier
1871504878
Registry record updated Jan 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Practice address
2412 Corporate Ctr
Granite City, IL 62040-4192
Phone
(618) 931-3338
Fax
(618) 931-4905
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X IL Primary

Addresses

Primary practice location

2412 Corporate Ctr
Granite City, IL 62040-4192

Mailing address

2412 Corporate Ctr
Granite City, IL 62040-4192
Phone (618) 931-3338

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

LicenseStateTypeSpecialty
016-003533ILMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gitersonke Foot Clinic, PC Past Accepting new patients
Granite City Physicians Corp Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201132800000",
    "number": "1871504878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 CORPORATE CTR",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620404192",
            "telephone_number": "618-931-3338",
            "fax_number": "618-931-4905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 CORPORATE CTR",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620404192",
            "telephone_number": "618-931-3338",
            "fax_number": "618-931-4905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GITERSONKE",
        "first_name": "ALAN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2008-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granite City, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2008; 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.