Emmanuel Lagoutaris, DPM, LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

PO3053 Issued in FL

Legal business name

EMMANUEL LAGOUTARIS, DPM, LLC

Practice address

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

Phone

(904) 429-9859

NPI assigned

Feb 15, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Emmanuel Lagoutaris, D.P.M.NPI 1932180676

Title

Owner

Phone

(904) 429-9859

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Emmanuel D Lagoutaris, DPM

  • Primary Podiatric Medicine Podiatrist
  • Jacksonville, FL
  • NPI 1932180676
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1423958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482451200000",
    "number": "1972994770",
    "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": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923037",
            "telephone_number": "904-429-9859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 KINGSLEY LAKE DR",
            "address_2": "STE. 402",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923037",
            "telephone_number": "904-429-9859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMMANUEL LAGOUTARIS, DPM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-15",
        "last_updated": "2016-12-23",
        "status": "A",
        "authorized_official_last_name": "LAGOUTARIS",
        "authorized_official_first_name": "EMMANUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-429-9859",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Foot & Ankle Surgery Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.