Foot Solutions

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

FOOT SOLUTIONS

Practice address

5759 Pacific Ave
Suite B120
Stockton, CA 95207-5162

Phone

(209) 337-0076

Fax

(209) 337-0279

NPI assigned

Dec 6, 2006

Organization subpart

No

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

Authorized official

Name

Allyn Kip Odermatt

Title

Owner

Phone

(209) 337-0076

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313020800000",
    "number": "1235298159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5759 PACIFIC AVE",
            "address_2": "SUITE B120",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075162",
            "telephone_number": "209-337-0076",
            "fax_number": "209-337-0279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5759 PACIFIC AVE",
            "address_2": "SUITE B120",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075162",
            "telephone_number": "209-337-0076",
            "fax_number": "209-337-0279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2011-08-11",
        "status": "A",
        "authorized_official_last_name": "ODERMATT",
        "authorized_official_first_name": "ALLYN",
        "authorized_official_middle_name": "KIP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-337-0076"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER VENDOR NUMBER",
            "identifier": "016903001",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Chuck Fong, D.D.S.
• Scott Fong
• Theodore T. Fong, MD
• Brianna Fonseca
• Maria Fonseca
• Gina Foppiano
• James Forath, RN
• Andre Ford
• Arieonne Renee Ford
• Leigh A Ford, NP

• Durable Medical Equipment & Medical Supplies in Stockton, CA
• Providers in Stockton, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; 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.