BRUSH MOUNTAIN SHOE (NPI# 1366476608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366476608 |
| Entity Type | Organization |
| Organization Name | BRUSH MOUNTAIN SHOE |
| Other Organization Name | LASSER'S SHOE FLY |
| Practice Address |
3415 Pleasant Valley Blvd Altoona PA 16602-4321 |
| Practice Telephone | 8149412132 |
| Practice Fax Number | 8149414491 |
| Mailing Telephone | 8149412132 |
| Mailing Fax Number | 8149414491 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2008-05-21 |
| Authorized Official Name | CHARLES WAYNE BIDDLE (SECRETARY) |
| Authorized Official Telephone | 8146848040 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | BCP9905 | PA | Podiatric Medicine & Surgery Service Providers |
| Other Name | Type Code |
|---|---|
| Lasser's Shoe Fly | Doing Business As Name - Organization |
| Street Address |
3415 PLEASANT VALLEY BLVD |
| City | ALTOONA |
| State | PA |
| Zip Code | 16602-4321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043817646 | John Francis Cain | Registered Nurse | 319 Meadowlark Ave, Altoona, PA 16602 | 2020-10-06 |
| 1023650991 | Rahaf Obeid | Pharmacist | 508 E Plank Road, Altoona, PA 16602 | 2019-10-12 |
| 1346713641 | Justin M Delasko | Dietitian, Registered | 905 Logan Blvd, Altoona, PA 16602 | 2019-01-09 |
| 1679932420 | Dottie Jean Morgan | Speech-Language Pathologist | 501 Valley View Blvd., Altoona, PA 16602 | 2016-02-22 |
| 1922409283 | Rite Aid of Pennsylvania LLC | Durable Medical Equipment & Medical Supplies | 1600 9th Avenue, Altoona, PA 16602 | 2014-09-05 |
| 1972918878 | Grane Hospice Care, Inc. | Hospice Care, Community Based | 115 Union Ave Ste 100, Altoona, PA 16602 | 2014-06-30 |
| 1033524921 | Grane Hospice Care, Inc. | Home Health | 115 Union Ave Ste 300, Altoona, PA 16602 | 2014-06-30 |
| 1306184858 | Lighthouse Medical, LLC | Physical Medicine & Rehabilitation | 301 E. Pleasant Valley Blvd, Altoona, PA 16602 | 2013-01-17 |
| 1497042576 | Michala Seidel | Counselor | 3010 7th Avenue, Alternative Community Resource Program, Altoona, PA 16602 | 2011-07-08 |
| 1205121647 | Rebekah Brown | Preventive Medicine | 301 E Pleasant Valley Blvd., Altoona, PA 16602 | 2011-06-14 |
| Find all providers in zip 16602 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043239593 | Brian Lee Gates | Podiatrist | 521 Logan Boulevard Lakemont, Altoona, PA 16602-5619 | 2006-07-18 |
| 1568400521 | Gary A Raymond, Dpm, PC | Podiatrist | 711 Logan Ave, Altoona, PA 16602-4831 | 2006-06-03 |
| 1487632428 | Donald E Mrdjenovich | Podiatrist | 2727 Beale Ave, Suite A, Altoona, PA 16601-1705 | 2006-01-09 |
| 1134537384 | James Edward Repko | Podiatrist | 711 Logan Blvd, Altoona, PA 16602 | 2014-07-31 |
| 1780942045 | Ryan J Donegan | Podiatrist | 1200 Oakleaf Way Ste A, Altoona, WI 54720-2245 | 2012-04-24 |
| 1376811570 | Gary A Raymond Dpm PC | Podiatrist | 711 Logan Blvd, Altoona, PA 16602-4165 | 2011-12-02 |
| 1689837650 | Kirstyn D Caldwell | Podiatrist | 2727 Beale Ave, Suite A, Altoona, PA 16601-1705 | 2008-07-09 |
| 1629146352 | Brian L Gates Dpm PC | Podiatrist | 521 Logan Boulevard Lakemont, Altoona, PA 16602-5619 | 2006-12-01 |
| 1134156979 | Blair Medical Associates | Podiatrist | 1414 9th Ave, Altoona, PA 16602-2454 | 2006-06-27 |
| 1033159538 | Matthew T Sabol | Podiatrist | 711 Logan Blvd, Altoona, PA 16602-4165 | 2006-06-07 |
| Find all providers in ALTOONA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.