NPIMap

Organization Active NPI

John S Balknap DPM PC

Doing business as Mt. Hood Podiatry The Dalles

  • Foot & Ankle Surgery Podiatrist
  • The Dalles, OR
National Provider Identifier
1922379379
Registry record updated Jan 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
JOHN S BALKNAP DPM PC
Doing business as
Mt. Hood Podiatry The Dalles
Practice address
1716 E 12TH St
The Dalles, OR 97058-3137
Phone
(541) 296-1006
Fax
(541) 298-1613
NPI assigned
Jan 17, 2012
Last updated
Jan 17, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2012

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

Authorized official

Name
Veronica Lundmark
Title
Biller
Phone
(503) 228-7106

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

1716 E 12TH St
The Dalles, OR 97058-3137

Mailing address

1716 E 12TH St
The Dalles, OR 97058-3137
Phone (541) 296-1006

Other names 1

  • Mt. Hood Podiatry The Dalles Doing business as

National Provider Directory

National Provider Directory
Tax ID family
John S Balknap DPM PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1326758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326758400000",
    "number": "1922379379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 E 12TH ST",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583137",
            "telephone_number": "541-296-1006",
            "fax_number": "541-298-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 E 12TH ST",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583137",
            "telephone_number": "541-296-1006",
            "fax_number": "541-298-1613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN S BALKNAP DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-17",
        "last_updated": "2012-01-17",
        "status": "A",
        "authorized_official_last_name": "LUNDMARK",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "503-228-7106"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mt. Hood Podiatry The Dalles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in The Dalles, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2012; 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.