Individual provider Active NPI

Damon Payton, DPM

  • Foot & Ankle Surgery Podiatrist
  • Florissant, MO
National Provider Identifier
1649200502
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
16005263 Issued in IL
Practice address
2175 Orleans LN
Florissant, MO 63031-2111
Phone
(646) 623-0120
Fax
(314) 480-7162
NPI assigned
Jul 4, 2006
Last updated
Feb 5, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 16005263 IL Primary
Foot & Ankle Surgery Podiatrist 213ES0103X 6057 NY
Foot & Ankle Surgery Podiatrist 213ES0103X 2006013232 MO

Addresses

Primary practice location

2175 Orleans LN
Florissant, MO 63031-2111

Mailing address

2175 Orleans LN
Florissant, MO 63031-2111
Phone (646) 623-0120

Other practice location 1

1001 Morgan St
Carlinville, IL 62626-1448
Phone (646) 623-0120

Other identifiers 3

IdentifierTypeStateIssuer
0732240001OtherDMERC # WITH PPG
1649200502MedicaidMO
016005293MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, VA, IN3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20070302000057 MO Practitioner - Podiatry 0446286504 Reassigns benefits to 2 organizations
I20120214000324 VA Practitioner - Podiatry 0446286504 Reassigns benefits to 1 organization
I20170419002124 IN Practitioner - Podiatry 0446286504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Louis Medical Clinic, P.C.Group PAC ID 2961496765, 11 clinicians

Practice addresses (Care Compare)

3009 N Ballas Rd
Saint Louis, MO 63131-2322
Phone (314) 432-1111

3300 Texas Ave
Saint Louis, MO 63118-3111
Phone (314) 773-3408

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue15
Removal of skin lesions1-10
Removal of nail tissue1322
Removal or shaving of skin growth142
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
006057NYMDAcupuncturist
16005263ILMDFoot & Ankle Surgery Podiatrist
2006013232MOMDFoot & Ankle Surgery Podiatrist
6057NYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Onhealthcare LLC CurrentSince Mar 19, 2017 Accepting new patients
St Louis Medical Clinic, P.C. CurrentSince Oct 3, 2023 Accepting new patients
Onhealthcare, LLC Current Accepting new patients
Onhealthcare LLC CurrentSince Mar 19, 2017 Accepting new patients
Family Foot and Ankle Care Past Accepting new patients
Community Living Options Inc Past Accepting new patients
St Louis University Past Accepting new patients
Physical Therapy Consultants, Inc Past Accepting new patients
Thomas H. Nolen, D.P.M., P.C. Foot & Ankle Surgery Past Accepting new patients
Thomas H. Nolen, D.P.M., P.C. Foot & Ankle Surgery Past Accepting new patients
Primehealth of Kentucky LLC Past Accepting new patients

Locations

8425 Woodfield Crossing Blvd
Ste 100
Indianapolis, IN 46240
Phone (317) 537-9522

12910 Shelbyville Rd
Ste 300
Louisville, KY 40243
Phone (502) 214-0693

1400 Lemay Ferry Rd
Saint Louis, MO 63125
Phone (314) 338-7955

3009 N Ballas Rd
Ste 100B
Saint Louis, MO 63131
Phone (314) 270-1796

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BDDCDD

Organizations & group practices 12

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1649200502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2175 ORLEANS LN",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630312111",
            "telephone_number": "646-623-0120",
            "fax_number": "314-480-7162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 ORLEANS LN",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630312111",
            "telephone_number": "646-623-0120",
            "fax_number": "314-480-7162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Morgan St",
            "address_purpose": "LOCATION",
            "city": "Carlinville",
            "state": "IL",
            "postal_code": "626261448",
            "country_code": "US",
            "telephone_number": "646-623-0120",
            "fax_number": "314-436-8821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAYTON",
        "first_name": "DAMON",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "16005263",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "6057",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "2006013232",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC # WITH PPG",
            "identifier": "0732240001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649200502",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016005293",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florissant, MO

Sources for this page

Verify at the official NPI Registry.