Pedorthic Footcare of Oklahoma

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

84 Issued in OK

Legal business name

PEDORTHIC FOOTCARE OF OKLAHOMA

Practice address

5100 N Brookline Ave Ste 330
Oklahoma City, OK 73112-3603

Phone

(405) 924-7306

Fax

(405) 600-7287

NPI assigned

Mar 12, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Kevin Jaeger, CPED, LPEDNPI 1992886998

Title

Certified & Licensed Pedorthist

Phone

(405) 924-7306

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin A Jaeger, CPED, LPED

  • Specialist
  • Oklahoma City, OK
  • NPI 1992886998
  NPD (past) Authorized official

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

{
    "created_epoch": "1331510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334188800000",
    "number": "1093080905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 N BROOKLINE AVE STE 330",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731123603",
            "telephone_number": "405-924-7306",
            "fax_number": "405-600-7287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 N BROOKLINE AVE STE 330",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731123603",
            "telephone_number": "405-924-7306",
            "fax_number": "405-600-7287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDORTHIC FOOTCARE OF OKLAHOMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-12",
        "last_updated": "2012-04-12",
        "status": "A",
        "authorized_official_last_name": "JAEGER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CERTIFIED & LICENSED PEDORTHIST",
        "authorized_official_telephone_number": "405-924-7306",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPED, LPED"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "OK",
            "license": "84",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric ENT of Oklahoma PLLC
• Pediatric Intensive Care Services Inc
• Pediatric Multispecialty Group PLLC
• Pediatric Neuropsychology Associates PLLC
• Pediatrix Medical Group of Oklahoma, P.C.
• Dominic M Pedulla, M.D.
• Carol A Peek
• Lauren Mariah Peek, CNA
• Mary Lynn Peeks, FNP-C
• Evonna Peery

• Prosthetic/Orthotic Supplier in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Prosthetic/Orthotic Supplier in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; 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.