THOMAS KEVIN BRATTAIN


Address: 3322 W Willow Knolls Dr, Peoria, IL 61614-8148
Phone: 3096915800

THOMAS KEVIN BRATTAIN (NPI# 1285613463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1285613463
Entity Type Individual
Full Name THOMAS KEVIN BRATTAIN
Credential DPM
Practice Address 3322 W Willow Knolls Dr
Peoria
IL 61614-8148
Practice Telephone 3096915800
Practice Fax Number 3096911336
Mailing Telephone 3096915800
Mailing Fax Number 3096911336
Enumeration Date 2006-01-16
Last Update Date 2008-04-03
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 213E00000X Podiatrist 016003267 IL Podiatric Medicine & Surgery Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
IL MEDICARE RAILROAD 480009789 01
IL 016003267 05
IL BLUE CROSS BLUE SHIELD 0007215174 01
IL MEDICARE PROVIDER NUMBER 928270 01

Office Location

Street Address 3322 W WILLOW KNOLLS DR
City PEORIA
State IL
Zip Code 61614-8148

Providers in the same location

NPI Name Taxonomy Address Enumeration
1336549427 Patricia Geffre-starr Massage Therapist 3322 W Willow Knolls Dr, Peoria, IL 61614-8148 2014-08-26
1447659008 Michelle L Carlson Massage Therapist 3322 W Willow Knolls Dr, Suite B, Peoria, IL 61614-8148 2014-08-20
1518387109 Justin R. Ahlman, M.d. Anesthesiology 3322 W Willow Knolls Dr, Peoria, IL 61614-8148 2014-04-22
1093885378 Mark Alan Smith Podiatrist 3322 W Willow Knolls Dr, Peoria, IL 61614 2006-11-08

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1548818511 Christine Svoboda Social Worker 6919 N Knoxville Ave Ste 100 and 202, Peoria, IL 61614 2019-09-03
1639649007 Kathy Karouzos Counseling, LLC Clinic/Center 330 W. Ivy Ln., Peoria, IL 61614 2018-11-28
1205312790 Kathleen Marie Hendricks Nurse Practitioner 2809 W Willow Knolls Dr, Peoria, IL 61614 2018-07-17
1629563937 Mary Elizabeth Cunningham Counselor 6219 N. Eldorado Dr., Peoria, IL 61614 2018-06-28
1861937955 Angela Gilles Social Worker 6919 N Knoxville Ave Ste 100, Peoria, IL 61614 2016-12-27
1467994897 Melissa Saxsma Specialist 5009 N Executive Dr, Peoria, IL 61614 2016-11-16
1902258874 Rashid Plastic Surgery, LLC Plastic Surgery 804 W Trailcreek Drive, Peoria, IL 61614 2016-07-05
1215313143 Melissa Lynn Phelan Nurse Practitioner 122 E Morningside Dr, Peoria, IL 61614 2015-08-03
1811380165 All Ways Caring Services, Inc. In Home Supportive Care 6919 N Knoxville Ave, Suite 102, Peoria, IL 61614 2015-03-11
1568875920 Schuler & Arkwell Orthodontic Partnership Dentist 2425 Cornerstone Ct. Ste. A, Peoria, IL 61614 2014-06-03
Find all providers in zip 61614

Taxonomy Information

Taxonomy Code 213E00000X
Grouping Podiatric Medicine & Surgery Service Providers
Classification Podiatrist

Taxonomy Definition

A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1699065839 Keith Bangart Dpm PC Podiatrist 13660 N 94th Dr Ste F1, Peoria, AZ 85381-4232 2011-04-08
1962689489 Dan Bangart Plc Podiatrist 13660 N 94th Drive, Suite F-1, Peoria, AZ 85381-4323 2008-01-28
1770540700 Teisha M Kubala Podiatrist 8325 W Happy Valley Rd, Unit 105, Peoria, AZ 85383-4361 2006-04-26
1336135177 David M Bates Podiatrist 15182 N 75th Ave, Ste 160, Peoria, AZ 85381-4722 2005-09-27
1689939985 Annie Jong Podiatrist 13660 N 94th Dr, Ste A3, Peoria, AZ 85381-4836 2012-07-12
1306101571 Steven Shane Moore Podiatrist 13660 N 94th Dr Ste F1, Peoria, AZ 85381-4232 2012-07-12
1013216373 Keith Thomas Bangart Podiatrist 13660 N 94th Dr, #f1, Peoria, AZ 85381-4836 2011-03-24
1689978397 Edward Au Podiatrist 9171 W Thunderbird Rd, Ste 101, Peoria, AZ 85381-4872 2011-01-10
1629208723 John Charles Hart Podiatrist 300 E War Memorial Dr, Suite 200, Peoria, IL 61614-7570 2009-07-23
1982817912 Achilles Heel LLC Podiatrist 13660 N 94th Dr, Ste A-3, Peoria, AZ 85381-4836 2007-05-07
Find all providers in PEORIA

Competitor

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City PEORIA
Zip Code 61614

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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