Red Wing Shoes

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

RED WING SHOES

Practice address

11614 N Dale Mabry Hwy
Tampa, FL 33618-3502

Phone

(813) 969-4785

NPI assigned

Apr 28, 2017

Organization subpart

No

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

Authorized official

Name

Donna Lynn Walters

Title

Manager

Phone

(813) 969-4785

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493337600000",
    "number": "1174058002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11614 N DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336183502",
            "telephone_number": "813-969-4785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11614 N DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336183502",
            "telephone_number": "813-969-4785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED WING SHOES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-28",
        "last_updated": "2017-04-28",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "813-969-4785"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Recover Life Inc
• Recovercare, LLC
• Recovery From Society LLC.
• Recovery Is Hope, LLC
• Recruiting Marketing Consultants Corporation
• Jason Redd, CPO, LPO
• John L Redd, DMD
• Lauren Redd
• Erica Lynn Reddig, LCSW
• Angielisa Diane Redding

• Durable Medical Equipment & Medical Supplies in Tampa, FL
• Providers in Tampa, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2017; 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.