John Demetrios Lagoutaris, D.P.M.

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

PO 3240 Issued in FL

Practice address

300 Kingsley Lake Dr
Ste. 402
Saint Augustine, FL 32092-3037

Phone

(904) 826-1375

Fax

(904) 779-4964

NPI assigned

Jul 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439164800000",
    "number": "1780690867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 KINGSLEY LAKE DR",
            "address_2": "STE. 402",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320923037",
            "telephone_number": "904-429-9859",
            "fax_number": "904-429-9862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 KINGSLEY LAKE DR",
            "address_2": "STE. 402",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320923037",
            "telephone_number": "904-826-1375",
            "fax_number": "904-779-4964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGOUTARIS",
        "first_name": "JOHN",
        "middle_name": "DEMETRIOS",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2015-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "FL",
            "license": "PO 3240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Jane Lachance, PHARM.D.
• Amanda Lachappelle, MS
• Simeon De'Ja B. Ladd, M.S., SLP
• Alice P Laflamme, OD
• Tammy Louise Lagasse, P.T.A., L.M.T
• Katelyn Lally
• Karen E. Laman
• Benjamin Lambert, LMT
• Natalie Dawn Lambie, D.O.
• Alexander Jeffrey Lampley, MD

• Foot Surgery Podiatrist in Saint Augustine, FL
• Providers in Saint Augustine, FL by specialty
• Foot Surgery Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.