Organization Active NPI

Rudolph Lafontant, DPM, PC

  • Podiatrist
  • West Des Moines, IA
National Provider Identifier
1801075858
Registry record updated Sep 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
00597 Issued in IA
Legal business name
RUDOLPH LAFONTANT, DPM, PC
Practice address
1701 22ND St Ste 105
West Des Moines, IA 50266-1443
Phone
(515) 963-9464
Fax
(515) 963-9467
NPI assigned
Oct 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2009

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

Authorized official

Name
Mr. Kyle Shupe
Title
Ceo
Phone
(515) 963-9464

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 00597 IA Primary

Addresses

Primary practice location

1701 22ND St Ste 105
West Des Moines, IA 50266-1443

Mailing address

1701 22ND St Ste 105
West Des Moines, IA 50266-1443
Phone (515) 963-9464

Other identifiers 3

IdentifierTypeStateIssuer
DE4738OtherRAILROAD MEDICARE
0934390001OtherIADMERC
0415927MedicaidIA

National Provider Directory

National Provider Directory

Locations

2600 University Ave
Ste 206
West Des Moines, IA 50266
Phone (515) 223-5219

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251849600000",
    "number": "1801075858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 22ND ST STE 105",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661443",
            "telephone_number": "515-963-9464",
            "fax_number": "515-963-9467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 22ND ST STE 105",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661443",
            "telephone_number": "515-963-9464",
            "fax_number": "515-963-9467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUDOLPH LAFONTANT, DPM, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-26",
        "last_updated": "2009-09-02",
        "status": "A",
        "authorized_official_last_name": "SHUPE",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "515-963-9464",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IA",
            "license": "00597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE4738",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0934390001",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0415927",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2009; 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.