PACIFIC FOOTWEAR COMPANY INC (NPI# 1841581717) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841581717 |
| Entity Type | Organization |
| Organization Name | PACIFIC FOOTWEAR COMPANY INC |
| Other Organization Name | PRIORITY FOOTWEAR & PEDORTHIC SERVICES |
| Practice Address |
1150 Knutson Ave Suite 12 Medford OR 97504-3100 |
| Mailing Address |
10240 Sw Nimbus Ave Suite L1 Portland OR 97223-4358 |
| Practice Telephone | 5476087400 |
| Practice Fax Number | 5416087600 |
| Mailing Telephone | 5035249565 |
| Mailing Fax Number | 5035248397 |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2011-04-27 |
| Authorized Official Name | DAVID REIMANN (PRESIDENT) |
| Authorized Official Telephone | 5035249656 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 297988 | 05 |
| Other Name | Type Code |
|---|---|
| Priority Footwear & Pedorthic Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871733683 | Pacific Footwear Company Inc | Prosthetic/Orthotic Supplier | 1010 N Normandie St, Ste 301, Spokane, WA 99201-2270 | 2009-03-06 |
| 1558316851 | Pacific Footwear Company Inc | Durable Medical Equipment & Medical Supplies | 10240 Sw Nimbus Ave, Suite L1, Portland, OR 97223-4358 | 2006-05-24 |
| 1831353200 | Pacific Footwear Company Inc | Durable Medical Equipment & Medical Supplies | 2150 N 107th St, Suite 204, Seattle, WA 98133-1305 | 2008-07-15 |
| Street Address |
1150 KNUTSON AVE SUITE 12 |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-3100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| 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 |
|---|---|---|---|---|
| 1174892640 | Cognitive Harmonics, Inc | Prosthetic/Orthotic Supplier | 2104 Hill Way, Medford, OR 97504-6208 | 2011-12-29 |
| 1942235445 | Spectrum Orthotics & Prosthetics Inc | Prosthetic/Orthotic Supplier | 1180 Crater Lake Ave, Medford, OR 97504 | 2006-07-12 |
| 1487014551 | Spectrum Orthotics & Prosthetics Inc | Prosthetic/Orthotic Supplier | 537 Murphy Rd, Suite B, Medford, OR 97504-8187 | 2016-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811500705 | Synergy Medical Systems, LLC | Prosthetic/Orthotic Supplier | 19365 Sw 65th Ave Ste 210, Tualatin, OR 97062-9196 | 2020-08-28 |
| 1881007607 | Shannon Levin | Prosthetic/Orthotic Supplier | 441 Union St Ne, Salem, OR 97301-2458 | 2014-06-09 |
| 1417257742 | A Step Forward LLC | Prosthetic/Orthotic Supplier | 744 Hawthorne Ave Ne, Salem, OR 97301-4675 | 2010-11-03 |
| 1467783761 | Elliott Pedorthic Care LLC | Prosthetic/Orthotic Supplier | 85084 Kensington Dr, Pleasant Hill, OR 97455-9621 | 2010-01-26 |
| 1780836049 | Angel Hair Foundation Inc | Prosthetic/Orthotic Supplier | 2783 Suncrest Ave, Eugene, OR 97405-5923 | 2008-10-17 |
| 1295986065 | Mirage Hair Systems, Inc. | Prosthetic/Orthotic Supplier | Suite 210 Oakway Ctr, Suite 210, Eugene, OR 97401-5618 | 2008-10-09 |
| 1457517138 | Genesis Medical Group, LLC. | Prosthetic/Orthotic Supplier | 16679 Boones Ferry Rd Ste 215, Lake Oswego, OR 97035-4368 | 2008-08-01 |
| 1518148105 | Paradox Walkfit Inc. | Prosthetic/Orthotic Supplier | 15532 Sw Pacific Hwy, Suite C1a, Tigard, OR 97224-3598 | 2007-11-24 |
| 1821286501 | Willamette Orthotics & Prosthetics LLC | Prosthetic/Orthotic Supplier | 333 Nw Larch Ave Ste 1, Redmond, OR 97756-1359 | 2007-10-09 |
| 1659569325 | Willamette Orthotics & Prosthetics LLC | Prosthetic/Orthotic Supplier | 345 Se Norton Ln Ste A, Mcminnville, OR 97128-8480 | 2007-10-09 |
| Find all providers with the same taxonomy | ||||
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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.