My Foot RX LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

MY FOOT RX LLC

Practice address

1706 York St
Unit #3
Bloomer, WI 54724-1920

Phone

(715) 577-9098

NPI assigned

Dec 28, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Robert C MC Roberts Jr., C.PEDNPI 1417492679

Title

Owner

Phone

(715) 568-1500

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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.

• Robert MC Roberts Jr., C.PED

  • Pedorthist
  • Bloomer, WI
  • NPI 1417492679
  NPD Authorized official

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

{
    "created_epoch": "1482883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515369600000",
    "number": "1033654199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 YORK ST STE 3",
            "city": "BLOOMER",
            "state": "WI",
            "postal_code": "547241921",
            "telephone_number": "715-568-1500",
            "fax_number": "715-568-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 YORK ST",
            "address_2": "UNIT #3",
            "city": "BLOOMER",
            "state": "WI",
            "postal_code": "547241920",
            "telephone_number": "715-577-9098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY FOOT RX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-28",
        "last_updated": "2018-01-08",
        "status": "A",
        "authorized_official_last_name": "MC ROBERTS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-568-1500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "C.PED"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Midwest Physical Therapy, Inc
• Gregory A Mihm, DDS
• Angela Ming
• Kelly Montag, PTA
• Lee F. Morissette, PA-C
• Rebecca Myers, M.S., CCC-SLP
• Lauren Nelson-Bobb, MPT
• Carol Newton, RDH
• Kimberly Carol Nicolai
• Maya Ninnemann

• Prosthetic/Orthotic Supplier in Bloomer, WI
• Providers in Bloomer, WI by specialty
• Prosthetic/Orthotic Supplier in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2018; 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.