Active NPI
Foot Health Centers PC
- Foot & Ankle Surgery Podiatrist
- Maryville, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 060-004872
- Legal business name
- FOOT HEALTH CENTERS PC
- Practice address
- 122 E Zupan St
Maryville, IL 62062-2010 - Phone
- (618) 344-4449
- Fax
- (618) 344-4551
- NPI assigned
- Jul 8, 2006
- Last updated
- May 23, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gina M Reagan
- Title
- Office Administrator
- Phone
- (618) 344-4449
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 060-004872 | IL | Primary |
Addresses
Primary practice location
122 E Zupan St
Maryville, IL 62062-2010
Mailing address
122 E Zupan St
Maryville, IL 62062-2010
Phone (618) 344-4449
Other practice location 1
5400 N Illinois St Ste 104
Fairview Heights, IL 62208-3563
Phone (618) 344-4449
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 060101285 | Other | IL | BC/BS GROUP# |
| CB0674 | Other | IL | RAILROAD MEDICARE GROUP# |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, MO
Enrollment records 3
National Provider Directory
National Provider DirectoryLocations
1735 Main St
Alton, IL 62002
Phone (618) 462-3888
4325 Alby St
Ste 200
Alton, IL 62002
Phone (618) 462-3888
5400 N Illinois St
Fairview Heights, IL 62208
5400 N Illinois St
Ste 104
Fairview Heights, IL 62208
Phone (618) 235-1500
122 E Zupan St
Maryville, IL 62062
Phone (618) 344-4449
Practitioners & affiliated clinicians
Practitioners 6
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.
-
- Foot & Ankle Surgery Podiatrist
- O'Fallon, MO
- NPI 1124165428
-
- Foot & Ankle Surgery Podiatrist
- Maryville, IL
- NPI 1942280789
-
- Podiatrist
- Alton, IL
- NPI 1851427819
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152316800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1716422400000",
"number": "1912930793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 E ZUPAN ST",
"city": "MARYVILLE",
"state": "IL",
"postal_code": "620622010",
"telephone_number": "618-344-4449",
"fax_number": "618-344-4551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122 E ZUPAN ST",
"city": "MARYVILLE",
"state": "IL",
"postal_code": "620622010",
"telephone_number": "618-344-4449",
"fax_number": "618-344-4551"
}
],
"practiceLocations": [
{
"address_1": "5400 N Illinois St Ste 104",
"address_purpose": "LOCATION",
"city": "Fairview Heights",
"state": "IL",
"postal_code": "622083563",
"country_code": "US",
"telephone_number": "618-344-4449",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "FOOT HEALTH CENTERS PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-08",
"last_updated": "2024-05-23",
"certification_date": "2024-05-20",
"status": "A",
"authorized_official_last_name": "REAGAN",
"authorized_official_first_name": "GINA",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
"authorized_official_telephone_number": "618-344-4449"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "IL",
"license": "060-004872",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS GROUP#",
"identifier": "060101285",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE GROUP#",
"identifier": "CB0674",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Maryville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.