Vagabond Shoes, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

VAGABOND SHOES, INC.

Practice address

635 Bay Park SQ
Green Bay, WI 54304-5101

Phone

(920) 606-0163

Fax

(920) 498-2429

NPI assigned

Sep 23, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Kathleen M Kelnhofer

Title

Owner

Phone

(920) 606-0163

Specialties & licenses 1

Addresses

Tax ID family

Vagabond Shoes Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Vagabond Shoes, Inc.

  • Prosthetic/Orthotic Supplier
  • Appleton, WI
  • NPI 1861407561
  NPD tax ID

Locations

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

{
    "created_epoch": "1158969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356441950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 BAY PARK SQ",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045101",
            "telephone_number": "920-606-0163",
            "fax_number": "920-498-2429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 BAY PARK SQ",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045101",
            "telephone_number": "920-606-0163",
            "fax_number": "920-498-2429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAGABOND SHOES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELNHOFER",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-606-0163",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Isabel Useem, D.O, MPH
• John W Utrie, DO
• Paul C Utrie, MD
• Molly Marie Uvaas, PA-C
• Christy Vachavake
• Dhwani A Vaishnav, MD
• Alexandra Deniz Valdez
• Dylan A. Valentine, DNP
• Lynette M. Valentine, R.N.
• Michelle Valenzuela, MS

• Prosthetic/Orthotic Supplier in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Prosthetic/Orthotic Supplier in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.