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KIRK M BOTT DBA LOGAN AVENUE FOOT CLINIC
NPI 1639391907
Podiatrist - Foot & Ankle Surgery in Danville, IL

Active since May 03, 2007
612 N LOGAN AVENUE, DANVILLE, IL 61832(217) 442-4186 Get Directions Write a Review

NPPES record last updated: June 18, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kirk M Bott Dba Logan Avenue Foot Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIRK M BOTT DBA LOGAN AVENUE FOOT CLINIC (NPI 1639391907) is a healthcare organization registered as a foot & ankle surgery in Danville, Illinois and active in the NPI registry since May 2007. The organization lists Kirk M Bott, Owner, as its authorized official.

NPPES Registry Identity

NPI1639391907
Entity TypeOrganization
Primary Taxonomy213ES0103X
Legal Business NameKIRK M BOTT DBA LOGAN AVENUE FOOT CLINIC
Location Address612 N LOGAN AVENUEDanville, IL 61832
Mailing Address612 N Logan AvenueDanville, IL 61832 · (217) 442-4186
Phone(217) 442-4186
Organization SubpartNo
Authorized OfficialKirk M BottOwner · (217) 442-4186
Enumeration DateMay 3, 2007
Last NPPES UpdateJune 18, 2008
✔ NPI 1639391907 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers
Taxonomy Code213ES0103X
License✔ Licensed in IL · 016003907
612 N LOGAN AVENUE, Danville, IL 61832
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Other Identifiers 11

Medicare ID-Type Unspecified961650IL · Logan Foot Clinic Group #
OtherP00380788Railroad Medicare Individ
Other480010681Railroad Medicare Individ
Medicare ID-Type Unspecified761930IL · Kirk M Bott Individual #
Other4449930001Dmerc
Other1376655019IL · Individual Npi #
Medicare UPINT38693IL
Other1649379504IL · Individual Npi #
OtherCE0883Railroad Medicare Group
Medicare UPINT83356IL
Medicare ID-Type Unspecified992890IL · Ronald E Cramer Dpm Ind#

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kirk M Bott Dba Logan Avenue Foot Clinic's NPI number?

The NPI number for Kirk M Bott Dba Logan Avenue Foot Clinic is 1639391907. It was assigned to this organization in the NPPES registry on May 3, 2007.

Where is Kirk M Bott Dba Logan Avenue Foot Clinic located?

Kirk M Bott Dba Logan Avenue Foot Clinic is located at 612 N Logan Avenue, Danville, IL 61832. The listed phone number is (217) 442-4186.

What is Kirk M Bott Dba Logan Avenue Foot Clinic's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

When was this NPI record last updated?

The NPPES record for Kirk M Bott Dba Logan Avenue Foot Clinic was last updated on June 18, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.