Brush Mountain Shoe

Primary specialty

PodiatristTaxonomy code 213E00000X

License

BCP9905 Issued in PA

Legal business name

BRUSH MOUNTAIN SHOE

Practice address

3415 Pleasant Valley Blvd
Altoona, PA 16602-4321

Phone

(814) 941-2132

Fax

(814) 941-4491

NPI assigned

Jul 11, 2006

Organization subpart

No

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

Authorized official

Name

Charles Wayne Biddle

Title

Secretary

Phone

(814) 684-8040

Specialties & licenses 1

Addresses

Other names 1

• Lasser's Shoe Fly Doing business as

Locations

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1366476608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 PLEASANT VALLEY BLVD",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166024321",
            "telephone_number": "814-941-2132",
            "fax_number": "814-941-4491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 PLEASANT VALLEY BLVD",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166024321",
            "telephone_number": "814-941-2132",
            "fax_number": "814-941-4491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUSH MOUNTAIN SHOE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "BIDDLE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "814-684-8040"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "BCP9905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lasser's Shoe Fly",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Ann Brown
• Joshua Matthew Brown, PT, DPT
• Sarah Brown
• Jessica Brubaker, ASSOC
• Madison Brumbaugh
• Ronald J. Brzana, M.D.
• Jessica Buchan, PA-C
• Chelsea M Buchanan, CRNP
• Joanne Carol Buck, LMT
• Fred Edward Buckreis, CRNA

• Podiatrist in Altoona, PA
• Providers in Altoona, PA by specialty
• Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; 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.