Shoe Store, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

SHOE STORE, LLC

Practice address

12 N Main St
Honeoye Falls, NY 14472-1071

Phone

(180) 091-3746

NPI assigned

Jul 22, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Daran Bedenbaugh

Title

Accounting Manager

Phone

(352) 538-3376

Specialties & licenses 1

Addresses

Other names 1

• Oppedisano's Bootery Doing business as

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

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374451200000",
    "number": "1669814406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 N MAIN ST",
            "city": "HONEOYE FALLS",
            "state": "NY",
            "postal_code": "144721071",
            "telephone_number": "180-091-3746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 N MAIN ST",
            "city": "HONEOYE FALLS",
            "state": "NY",
            "postal_code": "144721071",
            "telephone_number": "180-091-3746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOE STORE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-22",
        "last_updated": "2013-07-22",
        "status": "A",
        "authorized_official_last_name": "BEDENBAUGH",
        "authorized_official_first_name": "DARAN",
        "authorized_official_title_or_position": "ACCOUNTING MANAGER",
        "authorized_official_telephone_number": "352-538-3376",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oppedisano's Bootery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeanne M Schum, LCSW
• Pamela S Scully, LMT
• Janeen Hope Shaffer
• Dana Sharp
• Anthony Curtis Shideler, D.D.S.
• Sarah P Smith, DPT
• Spencer Pharmaceutical Group LLC
• Erica Marin Spencer, PHARM D
• Mark Allen Spezzano, PHD, LCSW-R
• Marianne Springstead-Rose, SPECIAL EDUCATOR

• Prosthetic/Orthotic Supplier in Honeoye Falls, NY
• Providers in Honeoye Falls, NY by specialty
• Prosthetic/Orthotic Supplier in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2013; 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.