Organization Active NPI

La Kocur Wilde PC

  • Podiatrist
  • King of Prussia, PA
National Provider Identifier
1073817300
Registry record updated Dec 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC003384L Issued in PA
Legal business name
LA KOCUR WILDE PC
Practice address
134 Rebel Rd
King of Prussia, PA 19406-2383
Phone
(215) 696-6078
Fax
(610) 265-2695
NPI assigned
Dec 30, 2010
Last updated
Dec 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2010

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

Authorized official

Name
Dr. Lori A Kocur, DPM
Title
President
Phone
(215) 696-6078

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC003384L PA Primary

Addresses

Primary practice location

134 Rebel Rd
King of Prussia, PA 19406-2383

Mailing address

134 Rebel Rd
King of Prussia, PA 19406-2383
Phone (215) 696-6078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110126000803 PA Part B Supplier - Clinic/Group Practice 5294914925 Receives reassigned benefits from 1 practitioner
Practice locations: King of Prussia, PA

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1293667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293667200000",
    "number": "1073817300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 REBEL RD",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062383",
            "telephone_number": "215-696-6078",
            "fax_number": "610-265-2695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 REBEL RD",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062383",
            "telephone_number": "215-696-6078",
            "fax_number": "610-265-2695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA KOCUR WILDE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-30",
        "last_updated": "2010-12-30",
        "status": "A",
        "authorized_official_last_name": "KOCUR",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-696-6078",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC003384L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in King of Prussia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2010; 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.

Verify at the official NPI Registry.