Quality Cobbler Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

QUALITY COBBLER INC

Practice address

1903 Park Ave
Muscatine Mall
Muscatine, IA 52761-5400

Phone

(563) 263-9372

NPI assigned

Jul 7, 2006

Last updated

Aug 22, 2020By 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

Mr. Larry J Miller, OST

Title

President

Phone

(563) 263-9372

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1568494516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 PARK AVE",
            "address_2": "MUSCATINE MALL",
            "city": "MUSCATINE",
            "state": "IA",
            "postal_code": "527615400",
            "telephone_number": "563-263-9372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 PARK AVE",
            "address_2": "MUSCATINE MALL",
            "city": "MUSCATINE",
            "state": "IA",
            "postal_code": "527615400",
            "telephone_number": "563-263-9372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALITY COBBLER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "563-263-9372",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OST"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0433763",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Premier Estates of Muscatine, LLC (Premier Estates of Muscatine)
• Desiree R Price, DNP, AGNP-C
• Anna Prier, OD
• Vickie Lynn Proctor, CMA
• Brian William Proffitt, DDS
• Cindy C. Rada, RD, LD
• Radiologic Medical Services, Pro Corp (Muscatine Radiology, PC)
• Veronica Reavis, LAC
• Paul Raymond Reeb, SLP CCC
• Carly Reed

• Prosthetic/Orthotic Supplier in Muscatine, IA
• Providers in Muscatine, IA by specialty
• Prosthetic/Orthotic Supplier in Iowa

• 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.