NPIMap

Organization Active NPI

Optimum Foot Care

  • Prosthetic/Orthotic Supplier
  • San Antonio, TX
National Provider Identifier
1063854743
Registry record updated Aug 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
OPTIMUM FOOT CARE
Practice address
8000 Ih 10 W
Suite 600
San Antonio, TX 78230-3802
Phone
(210) 417-5353
NPI assigned
Jul 23, 2013
Last updated
Aug 8, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2013

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

Authorized official

Name
Mr. Ernest H WallaceNPI 1942612551
Title
Owner-President
Phone
(757) 503-2196

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X NU
Oxygen Equipment & Supplies (DME) 332BX2000X NU
Prosthetic/Orthotic Supplier 335E00000X NU Primary

Addresses

Primary practice location

8000 Ih 10 W
Suite 600
San Antonio, TX 78230-3802

Mailing address

4836 Walters Cir
Unit a
Fort Sill, OK 73503-5010
Phone (580) 574-8414

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375920000000",
    "number": "1063854743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4836 WALTERS CIR",
            "address_2": "UNIT A",
            "city": "FORT SILL",
            "state": "OK",
            "postal_code": "735035010",
            "telephone_number": "580-574-8414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 IH 10 W",
            "address_2": "SUITE 600",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782303802",
            "telephone_number": "210-417-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM FOOT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-23",
        "last_updated": "2013-08-08",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER-PRESIDENT",
        "authorized_official_telephone_number": "757-503-2196",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; 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.