We Heel the Sole Podiatry LLC

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

794 Issued in TN

Legal business name

WE HEEL THE SOLE PODIATRY LLC

Practice address

1750 Madison Ave
Suite 260
Memphis, TN 38104-6492

Phone

(317) 441-1093

Fax

(317) 669-2739

NPI assigned

Sep 7, 2016

Organization subpart

No

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

Authorized official

Name

Jerwana Laster, DPMNPI 1528317518

Title

Owner

Phone

(317) 441-1093

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, IL, MO3 enrollments

Enrollment records 3

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• We Heel the Sole Podiatry LLC

  • Primary Podiatric Medicine Podiatrist
  • Indianapolis, IN
  • NPI 1457713406

  0648579243

  Same PAC ID

Tax ID family

We Heel the Sole Podiatry LLC2 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.

• We Heel the Sole Podiatry LLC

  • Primary Podiatric Medicine Podiatrist
  • Indianapolis, IN
  • NPI 1457713406
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jerwana Laster, DPM

  • Primary Podiatric Medicine Podiatrist
  • Indianapolis, IN
  • NPI 1528317518

  IL, MO, TN

  Medicare reassignment Authorized official
• Kelley Oralivia Holloway - Marshall

  • Foot & Ankle Surgery Podiatrist
  • Chicago, IL
  • NPI 1942593231
  NPD
• Eugenia C Malenkos, D.P.M.

  • Podiatrist
  • Indianapolis, IN
  • NPI 1992960124
  NPD

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1558818666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10935 BEECHWOOD DR E",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462801222",
            "telephone_number": "317-441-1093",
            "fax_number": "317-669-2739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 MADISON AVE",
            "address_2": "SUITE 260",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046492",
            "telephone_number": "317-441-1093",
            "fax_number": "317-669-2739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 Hickory St",
            "address_purpose": "LOCATION",
            "city": "Licking",
            "state": "MO",
            "postal_code": "655429847",
            "country_code": "US",
            "telephone_number": "217-728-2092",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17050 N Quality Lime Rd",
            "address_purpose": "LOCATION",
            "city": "Marshall",
            "state": "IL",
            "postal_code": "624414698",
            "country_code": "US",
            "telephone_number": "217-728-2092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WE HEEL THE SOLE PODIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-07",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A",
        "authorized_official_last_name": "LASTER",
        "authorized_official_first_name": "JERWANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-441-1093",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "TN",
            "license": "794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Podiatric Medicine Podiatrist in Memphis, TN
• Providers in Memphis, TN by specialty
• Primary Podiatric Medicine Podiatrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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.