Individual provider Active NPI

Joann Orphanos, DPM

  • Foot & Ankle Surgery Podiatrist
  • Gulfport, MS
National Provider Identifier
1720171002
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
80206 Issued in MS
Practice address
15095 Dedeaux Road
Gulfport, MS 39503-3284
Phone
(228) 243-1238
Fax
(228) 206-0503
NPI assigned
Oct 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 80206 MS Primary

Addresses

Primary practice location

15095 Dedeaux Road
Gulfport, MS 39503-3284

Mailing address

15095 Dedeaux Road
Gulfport, MS 39503-3284
Phone (228) 243-1238

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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 1

Enrollment IDStateProvider typePAC IDDetails
I20191209000495 MS Order and Referring Only - PodiatryPractitioner - Podiatry 9032282025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
80206MSMDFoot & Ankle Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1159660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305158400000",
    "number": "1720171002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15095 DEDEAUX ROAD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033284",
            "telephone_number": "228-243-1238",
            "fax_number": "228-206-0503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15095 DEDEAUX ROAD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033284",
            "telephone_number": "228-243-1238",
            "fax_number": "228-206-0503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORPHANOS",
        "first_name": "JOANN",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-01",
        "last_updated": "2011-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MS",
            "license": "80206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.