Southeastern Oklahoma Foot Technology, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

154 Issued in OK

Legal business name

SOUTHEASTERN OKLAHOMA FOOT TECHNOLOGY, LLC

Practice address

1 Choctaw Way
Talihina, OK 74571-2022

Phone

(918) 567-7000

NPI assigned

Oct 27, 2016

Last updated

Oct 27, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Denisia Lee Deramus, CPED

Title

Owner / Cped

Phone

(918) 567-7000

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

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

{
    "created_epoch": "1477526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477526400000",
    "number": "1356893192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 897",
            "city": "TALIHINA",
            "state": "OK",
            "postal_code": "745710897",
            "telephone_number": "918-567-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHOCTAW WAY",
            "city": "TALIHINA",
            "state": "OK",
            "postal_code": "745712022",
            "telephone_number": "918-567-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN OKLAHOMA FOOT TECHNOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-27",
        "last_updated": "2016-10-27",
        "status": "A",
        "authorized_official_last_name": "DERAMUS",
        "authorized_official_first_name": "DENISIA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER / CPED",
        "authorized_official_telephone_number": "918-567-7000",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CPED"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "OK",
            "license": "154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phillip Doyle Self, CRT
• Sara Elizabeth Shedd, RPH
• Irina Siritanu, MD
• Miriam Sloan, DDS
• Mary Nell Southard, R.D.,L.D.
• Southern Oklahoma Foot Technology LLC
• Britney Speer, RD
• Daniel Lee Stacy, DO
• Isaac Stacy
• State of Oklahoma

• Prosthetic/Orthotic Supplier in Talihina, OK
• Providers in Talihina, 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 Oct 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.