Jaffe Shoe Stores, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

NO STATE LICENSURE

Legal business name

JAFFE SHOE STORES, INC.

Practice address

5726 Marlin Rd
Suite 512
Chattanooga, TN 37411-4008

Phone

(423) 892-3366

Fax

(423) 892-3337

NPI assigned

Aug 27, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Sonny Sanders, C.PED

Title

President/Certiied Pedorthist

Phone

(423) 892-3366

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• sonny sanders, c.ped Doing business as

Locations

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

{
    "created_epoch": "1125100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013900729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80024",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374147024",
            "telephone_number": "423-892-3366",
            "fax_number": "423-892-3337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5726 MARLIN RD",
            "address_2": "SUITE 512",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374114008",
            "telephone_number": "423-892-3366",
            "fax_number": "423-892-3337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAFFE SHOE STORES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "SONNY",
        "authorized_official_title_or_position": "PRESIDENT/CERTIIED PEDORTHIST",
        "authorized_official_telephone_number": "423-892-3366",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "C.PED"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": "NO STATE LICENSURE",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1454284",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4043199",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "sonny sanders, c.ped",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Evans Jacobs, DO
• Edward L Jacobson, MD
• Samuel S Jacobson, MD
• Mark Allen Jacocks
• Alice Jada
• Salik Jahania, MD
• Hayden Erich Jahn, M.D.
• Marcus Steven Jakubiszak
• James E. Larson DDS, MSD
• Amira James, PT, DPT

• Prosthetic/Orthotic Supplier in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Prosthetic/Orthotic Supplier in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.