HAGOPIAN SHOES, LLC (NPI# 1760418099) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1760418099 |
Entity Type | Organization |
Organization Name | HAGOPIAN SHOES, LLC |
Other Organization Name | CLEARY'S SHOES & BOOTS |
Practice Address |
48 E Ferguson Ave Wood River IL 62095 |
Practice Telephone | 6182540276 |
Practice Fax Number | 6182541233 |
Mailing Telephone | 6182540276 |
Mailing Fax Number | 6182541233 |
Enumeration Date | 2006-06-26 |
Last Update Date | 2018-06-22 |
Authorized Official Name | MR. ANDREW HAGOPIAN (OWNER) |
Authorized Official Telephone | 6182540276 |
Authorized Official Credential | L.PED |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 335E00000X | Prosthetic/Orthotic Supplier | 212000071 | IL | Suppliers |
Other Name | Type Code |
---|---|
Cleary's Shoes & Boots | Doing Business As Name - Organization |
Street Address |
48 E FERGUSON AVE |
City | WOOD RIVER |
State | IL |
Zip Code | 62095 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467698068 | Jkh Management, LLC | Clinic/Center | 1138 Vaughn Road, Wood River, IL 62095 | 2009-01-02 |
1972762367 | Ronald Weems Jr P.C. | Dentist | 1915 Vaughn Road, Wood River, IL 62095 | 2008-06-02 |
1306010913 | Kristin Nicole Kellim | Specialist | 1138 Vaughn Rd, Wood River, IL 62095 | 2008-04-15 |
1124240569 | Denise Marie Jacquin | Optometrist | 650 Wesley Drive, Wood River Centre, Wood River, IL 62095 | 2007-05-03 |
1982734414 | Kathleen Crockett | Physical Therapist | 400 S Main, Wood River, IL 62095 | 2007-03-06 |
1336200286 | Johan C Dinkelmann | Chiropractor | 21 E Acton Ave, Wood River, IL 62095 | 2006-12-13 |
1063470524 | Jerseyville Pain Management Center, S.c. | Chiropractor | 1702 Vaughn Rd, Wood River, IL 62095 | 2006-05-03 |
1831354257 | Benjamin Hite | Dentist | 1915 Vaughn Road, Wood River, IL 62095 | 2008-07-24 |
1679797294 | Rhonda Nemsky | Developmental Therapist | 400 S Main, Wood River, IL 62095 | 2007-04-13 |
1770613218 | Frederic Golden | Psychologist | 400 S Main, Wood River, IL 62095 | 2007-03-06 |
Find all providers in zip 62095 |
Taxonomy Code | 335E00000X |
Grouping | Suppliers |
Classification | Prosthetic/Orthotic Supplier |
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952909517 | Matayah Love | Prosthetic/Orthotic Supplier | 5833 W Madison St, Chicago, IL 60644-3840 | 2020-10-15 |
1225653686 | Bionic Prosthetics and Orthotics Group LLC | Prosthetic/Orthotic Supplier | 1290 W Northwest Hwy, Palatine, IL 60067-1897 | 2020-06-11 |
1710508239 | Vivian Danielle Williams | Prosthetic/Orthotic Supplier | 940 N Monticello Ave # 1, Chicago, IL 60651-3949 | 2020-05-06 |
1265053136 | Dfined Beauty LLC | Prosthetic/Orthotic Supplier | 1507 E 53rd St # 835, Chicago, IL 60615-4573 | 2020-05-02 |
1134748767 | The Weave Luxe Bar | Prosthetic/Orthotic Supplier | 7315 Lemont Rd, Downers Grove, IL 60516-3807 | 2020-04-14 |
1245865245 | Ortheco LLC | Prosthetic/Orthotic Supplier | 3050 Montvale Dr Ste E, Springfield, IL 62704-4290 | 2020-03-10 |
1417515784 | Dionne Williams Group | Prosthetic/Orthotic Supplier | 6822 S Wood St, Chicago, IL 60636-3337 | 2019-06-03 |
1164080743 | Bionic Prosthetics and Orthotics Group LLC | Prosthetic/Orthotic Supplier | 391 Quadrangle Dr Ste N4, Bolingbrook, IL 60440-3443 | 2019-05-30 |
1760047583 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 13500 Circle Dr Ste 202, Orland Park, IL 60462-1343 | 2019-05-07 |
1114580107 | Thomas Gavin | Prosthetic/Orthotic Supplier | 1010 Jorie Blvd Ste 24, Oak Brook, IL 60523-4450 | 2019-04-16 |
Find all providers with the same taxonomy |
City | WOOD RIVER |
Zip Code | 62095 |
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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.