MIDSTATE PODIATRY ASSOCIATES LTD (NPI# 1548216047) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548216047 |
| Entity Type | Organization |
| Organization Name | MIDSTATE PODIATRY ASSOCIATES LTD |
| Practice Address |
2708 Mcgraw Dr Bloomington IL 61704-6012 |
| Practice Telephone | 3096632306 |
| Practice Fax Number | 3096621213 |
| Mailing Telephone | 3096632306 |
| Mailing Fax Number | 3096621213 |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2012-12-17 |
| Authorized Official Name | DR. H R HADDEN (PRESIDENT) |
| Authorized Official Telephone | 3096632306 |
| Authorized Official Credential | D.P.M. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 060-000800 | IL | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE SHIELD GROUP NUMBER | 60115936 | 01 |
| Street Address |
2708 MCGRAW DR |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61704-6012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235240250 | Kirk D Brock | Podiatrist | 2708 Mcgraw Dr, Bloomington, IL 61704-6012 | 2006-08-31 |
| 1215048202 | Joseph R Setter | Podiatrist | 2708 Mcgraw Dr, Bloomington, IL 61704-6012 | 2006-08-31 |
| 1710098652 | Wilbert M. Leonard | Podiatrist | 2708 Mcgraw Dr, Bloomington, IL 61704-6012 | 2006-08-31 |
| 1396766432 | H. Ross Hadden | Podiatrist | 2708 Mcgraw Dr, Bloomington, IL 61704-6012 | 2006-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518430859 | Visionpoint Eye Center LLC | Optometrist | 1107 Airport Road, Bloomington, IL 61704 | 2019-01-09 |
| 1922588235 | Geethu Sabu Makil | Speech-Language Pathologist | 1039 Blueheron Way, Apt#3, Bloomington, IL 61704 | 2018-08-16 |
| 1629596812 | Mental Wellness Center Inc | Counselor | 202 N Prospect Rd Ste 207, Bloomington, IL 61704 | 2017-09-07 |
| 1649798513 | Sarah Goodner | Psychologist | 1704 Royal Pointe Drive, Bloomington, IL 61704 | 2017-08-31 |
| 1346760253 | Elizabeth Devlin | Nurse Practitioner | 25 Long Cove Ct, Bloomington, IL 61704 | 2017-06-21 |
| 1396107918 | Darla Schwertfeger | Specialist/Technologist, Other | 2104 Hedgewood Dr, Bloomington, IL 61704 | 2016-03-23 |
| 1740662949 | Oncology Hematology Associates of Central Illinois | Pharmacy | 3105 Magory Drive, Bloomington, IL 61704 | 2015-06-24 |
| 1821478967 | Kelly R Andrews | Massage Therapist | 4101 Wicker Rd, Bloomington, IL 61704 | 2015-06-03 |
| 1235522582 | All Ways Caring Services, Inc. | In Home Supportive Care | 209 S Prospect Rd, Suite 3e, Bloomington, IL 61704 | 2015-03-11 |
| 1396093977 | Bhawna Gupta | Physical Therapist | 2200 East Washington Street, Bloomington, IL 61704 | 2012-08-29 |
| Find all providers in zip 61704 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609947571 | Kevin J Powers, Dpm | Podiatrist | 719 W 2nd St, Bloomington, IN 47403-2209 | 2006-11-13 |
| 1790791416 | Gerald W Paul | Podiatrist | 3801 Ge Rd Ste 4, Bloomington, IL 61704 | 2006-08-01 |
| 1154388460 | Abel R Aguilar | Podiatrist | 1416 W Caber Ct, Bloomington, IN 47403-7906 | 2006-04-28 |
| 1235101619 | Brian L Hamm | Podiatrist | 2502 E Empire St, Bloomington, IL 61704-3738 | 2006-02-01 |
| 1780117671 | Foot Specialist LLC | Podiatrist | 1416 W Caber Ct, Bloomington, IN 47403-7906 | 2017-04-06 |
| 1437598596 | Stephanie Danielle Van Heerden | Podiatrist | 583 S Clarizz Blvd, Bloomington, IN 47401-5515 | 2013-06-21 |
| 1902067291 | Heather Lynn Jensen | Podiatrist | 7920 Cedar Ave S, Bloomington, MN 55425 | 2008-06-19 |
| 1972620334 | Kevin Powers Dpm | Podiatrist | 2499 W Cota Dr, Bloomington, IN 47403-4217 | 2007-03-23 |
| 1285735712 | Kenneth Wesley Oglesby | Podiatrist | 583 S Clarizz Blvd, Bloomington, IN 47401-5515 | 2006-09-26 |
| 1801997358 | Foot and Ankle Center of Southern Indiana, LLC | Podiatrist | 419 W 1st St, Bloomington, IN 47403-2403 | 2006-09-26 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 61704 |
Please comment or provide details below to improve the information on MIDSTATE PODIATRY ASSOCIATES LTD.
| 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.