Portage Podiatry

Primary specialty

PodiatristTaxonomy code 213E00000X

License

SC004705L Issued in PA

Legal business name

PORTAGE PODIATRY

Practice address

713 Mountain Ave Ste 1
Portage, PA 15946-1756

Phone

(814) 736-5000

Fax

(814) 736-9616

NPI assigned

Feb 1, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Regina A Goughnour

Title

Office Manager

Phone

(814) 736-5000

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13355/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783296000000",
    "number": "1659559599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 MOUNTAIN AVE STE 1",
            "city": "PORTAGE",
            "state": "PA",
            "postal_code": "159461756",
            "telephone_number": "814-736-5000",
            "fax_number": "814-736-9616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 MOUNTAIN AVE STE 1",
            "city": "PORTAGE",
            "state": "PA",
            "postal_code": "159461756",
            "telephone_number": "814-736-5000",
            "fax_number": "814-736-9616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTAGE PODIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-01",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A",
        "authorized_official_last_name": "GOUGHNOUR",
        "authorized_official_first_name": "REGINA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "814-736-5000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC004705L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "043195",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phoenix Rehabilitation and Health Services, Inc.
• Pioneer Medical PA LLC
• Portage Area Ambulance Association
• Portage Area School District
• Portage Chiropractic, P.C.
• Jordan Rochelle Poruban
• Kayla Marie Radcliffe, PTA
• Mark J Ratchford, DO
• Deborah Ann Rauf, PT
• Lisa A Ritchey, RN

• Podiatrist in Portage, PA
• Providers in Portage, PA by specialty
• Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.