St. Cloud Podiatry Clinic, P.a.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

MN315 Issued in MN

Legal business name

ST. CLOUD PODIATRY CLINIC, P.A.

Practice address

17 7TH Ave S
Saint Cloud, MN 56301-4259

Phone

(320) 253-7533

Fax

(320) 654-8718

NPI assigned

Jan 10, 2007

Organization subpart

No

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

Authorized official

Name

Stephen E Lore, D.P.M.

Title

President

Phone

(320) 253-7533

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193011200000",
    "number": "1679622237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 7TH AVE S",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014259",
            "telephone_number": "320-253-7533",
            "fax_number": "320-654-8718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 7TH AVE S",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014259",
            "telephone_number": "320-253-7533",
            "fax_number": "320-654-8718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CLOUD PODIATRY CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-10-22",
        "status": "A",
        "authorized_official_last_name": "LORE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "320-253-7533",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MN",
            "license": "MN315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• St. Cloud Silver Lining, Inc
• St. Cloud State University
• St. Cloud Technical College Community Dental Clinic
• St. Cloud Vamc

• Podiatrist in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Podiatrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; 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.