Organization Active NPI

Acute Care Surgery Midwest, S.C.

  • Urology Physician
  • Peoria, IL
National Provider Identifier
1992380943
Registry record updated Jun 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
ACUTE CARE SURGERY MIDWEST, S.C.
Practice address
7309 N Knoxville Ave Ste 1
Peoria, IL 61614-2086
Phone
(916) 441-0400
NPI assigned
Mar 11, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2021

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

Authorized official

Name
Mr. Sean M. Reed
Title
Director of Legal Affairs
Phone
(916) 441-0400

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

7309 N Knoxville Ave Ste 1
Peoria, IL 61614-2086

Mailing address

PO Box 208980
Dallas, TX 75320-0001
Phone (916) 441-0400

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1615420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624579200000",
    "number": "1992380943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208980",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753200001",
            "telephone_number": "916-441-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7309 N KNOXVILLE AVE STE 1",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616142086",
            "telephone_number": "916-441-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACUTE CARE SURGERY MIDWEST, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-11",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "DIRECTOR OF LEGAL AFFAIRS",
        "authorized_official_telephone_number": "916-441-0400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; 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.