Heavenly Soles PLLC

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

0711 Issued in AZ

Legal business name

HEAVENLY SOLES PLLC

Practice address

13954 W Waddell Rd
Suite 307
Surprise, AZ 85379-8750

Phone

(623) 584-0760

Fax

(623) 546-0344

NPI assigned

Feb 27, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Marie C Paul, DPM

Title

Manager

Phone

(623) 584-0760

Specialties & licenses 6

Addresses

Locations

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

{
    "created_epoch": "1393459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478563200000",
    "number": "1114342169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13954 W WADDELL RD",
            "address_2": "SUITE 307",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853798750",
            "telephone_number": "623-584-0760",
            "fax_number": "623-546-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13954 W WADDELL RD",
            "address_2": "SUITE 307",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853798750",
            "telephone_number": "623-584-0760",
            "fax_number": "623-546-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLY SOLES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-27",
        "last_updated": "2016-11-08",
        "status": "A",
        "authorized_official_last_name": "PAUL",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "623-584-0760",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "AZ",
            "license": "0711",
            "primary": true
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "AZ",
            "license": "0711",
            "primary": false
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "AZ",
            "license": "0711",
            "primary": false
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "AZ",
            "license": "0711",
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "AZ",
            "license": "0711",
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "AZ",
            "license": "0711",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Podiatric Medicine Podiatrist in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Primary Podiatric Medicine Podiatrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; 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.