Lorene Ann Van Dam, DPM

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

686 Issued in MO

Practice address

4870 W Kingsbury St
Springfield, MO 65802-7710

Phone

(417) 299-7602

NPI assigned

Jan 28, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1169942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276128000000",
    "number": "1265588479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4870 W KINGSBURY ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658027710",
            "telephone_number": "417-299-7602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4870 W KINGSBURY ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658027710",
            "telephone_number": "417-299-7602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DAM",
        "first_name": "LORENE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-28",
        "last_updated": "2010-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "MO",
            "license": "686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larry M Valentine, MS, LPC
• Valhalla Medical LLC
• Valtara Tech LLC
• Valudental North Glenstone LLC
• Valudental Springfield LLC
• Corbin Van de Wege, MD
• Mark John Van Ess, D.O.
• Luke A Van Kirk, DO
• Alisyn L Van Note, MS, LPC
• Elisabeth Van Valkenburg

• Foot Surgery Podiatrist in Springfield, MO
• Providers in Springfield, MO by specialty
• Foot Surgery Podiatrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.