NPIMap

Individual provider Active NPI

Lori L Wilson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Uniontown, PA
National Provider Identifier
1679578249
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
SC003555R Issued in PA
Practice address
104 Delaware Ave
Suite 246
Uniontown, PA 15401-3100
Phone
(724) 439-1300
Fax
(724) 439-8727
NPI assigned
Jun 20, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X SC003555R PA
Foot Surgery Podiatrist 213ES0131X SC003555R PA
Podiatric Clinic/Center 261QP1100X SC003555R PA
Foot & Ankle Surgery Podiatrist 213ES0103X SC003555R PA Primary

Addresses

Primary practice location

104 Delaware Ave
Suite 246
Uniontown, PA 15401-3100

Mailing address

104 Delaware Ave
Suite 246
Uniontown, PA 15401-3100
Phone (724) 439-1300

Other identifiers 1

IdentifierTypeStateIssuer
001214510003MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100618000469 PA Practitioner - Podiatry 4082744990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novacare Outpatient Rehabilitation East, Inc.Group PAC ID 3678480290, shared by 15 NPIs, 493 clinicians

Practice addresses (Care Compare)

104 Delaware Ave
Suite 246
Uniontown, PA 15401-3100
Phone (724) 439-1300

2175 McClellandtown Rd
Suite Aandb
Masontown, PA 15461-2593
Phone (724) 491-5220

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue47
Removal of skin lesions1-10
Removal of nail tissue898
Removal or shaving of skin growth165

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC003555RPAMDContractor

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Foot and Ankle of Southwest PA Foot & Ankle Surgery CurrentSince Apr 1, 2014 Accepting new patients
Fayette Podiatry Associates Inc Foot & Ankle Surgery Current Accepting new patients

Locations

631A National Pike E
Brownsville, PA 15417
Phone (724) 785-8060

104 Delaware Ave
Ste 246
Uniontown, PA 15401
Phone (724) 439-1300

Interoperability endpoints

  • Direct secure messaging: wilsonhop@afaa-pa.direct.office.nextgen.com

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1679578249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 DELAWARE AVE",
            "address_2": "SUITE 246",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154013100",
            "telephone_number": "724-439-1300",
            "fax_number": "724-439-8727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 DELAWARE AVE",
            "address_2": "SUITE 246",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154013100",
            "telephone_number": "724-439-1300",
            "fax_number": "724-439-8727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LORI",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-20",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "PA",
            "license": "SC003555R",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "PA",
            "license": "SC003555R",
            "primary": false
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "PA",
            "license": "SC003555R",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC003555R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001214510003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Uniontown, PA

Sources for this page

Verify at the official NPI Registry.