Active NPI
Linda L Porter, D.P.M.
- Podiatrist
- O Fallon, MO
National Provider Identifier
1629070487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 000616
- Practice address
- 72 Rock Church Dr
O Fallon, MO 63368-8162 - Phone
- (636) 240-8821
- Fax
- (636) 294-1488
- NPI assigned
- Aug 11, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 000616 | MO | Primary |
Addresses
Primary practice location
72 Rock Church Dr
O Fallon, MO 63368-8162
Mailing address
72 Rock Church Dr
O Fallon, MO 63368-8162
Phone (636) 240-8821
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080416000323 | MO | Practitioner - Podiatry | 1759469778 | Practice locations: Saint Charles, MO; Wentzville, MO; O Fallon, MO |
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
72 Rock Church Dr
O Fallon, MO 63368-8162
Phone (636) 727-8821
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1365 |
| Removal or shaving of skin growth | 329 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000616 | MO | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208304000000",
"number": "1629070487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "72 ROCK CHURCH DR",
"city": "O FALLON",
"state": "MO",
"postal_code": "633688162",
"telephone_number": "636-240-8821",
"fax_number": "636-294-1488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "72 ROCK CHURCH DR",
"city": "O FALLON",
"state": "MO",
"postal_code": "633688162",
"telephone_number": "636-240-8821",
"fax_number": "636-294-1488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "LINDA",
"middle_name": "L",
"credential": "D.P.M.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-08-11",
"last_updated": "2008-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "MO",
"license": "000616",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in O Fallon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.