Individual provider Active NPI

Larry R Anthon, DPM

  • Foot & Ankle Surgery Podiatrist
  • Orange, CA
National Provider Identifier
1790974970
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E2667 Issued in CA
Practice address
3121 N Hartman St
Orange, CA 92865-1214
Phone
(951) 278-5590
Fax
(951) 272-9924
NPI assigned
Oct 23, 2007
Last updated
Jun 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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 E2667 CA Primary

Addresses

Primary practice location

3121 N Hartman St
Orange, CA 92865-1214

Mailing address

PO Box 77790
Corona, CA 92877-0126
Phone (800) 626-2468

Other identifiers 1

IdentifierTypeStateIssuer
000E26670MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20080609000257 TX Practitioner - Podiatry 7012087653 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E2667CAMDFoot & Ankle Surgery Podiatrist
2667CAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
L R Anthon DPM a Podiatry Corporation CurrentSince Sep 26, 2010 Accepting new patients
L R Anthon DPM a Professional Corporation Foot & Ankle Surgery CurrentSince Oct 18, 2007 Accepting new patients

Locations

1442 E Lincoln Ave
Orange, CA 92865
Phone (619) 500-3840

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1790974970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 77790",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928770126",
            "telephone_number": "800-626-2468",
            "fax_number": "951-272-9924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3121 N HARTMAN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928651214",
            "telephone_number": "951-278-5590",
            "fax_number": "951-272-9924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTHON",
        "first_name": "LARRY",
        "middle_name": "R",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-23",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E2667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E26670",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.