Susan Elaine Mitchell

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

SUSAN ELAINE MITCHELL

Practice address

1018 Main St
Suite B
Osage Beach, MO 65065-3033

Phone

(573) 348-6767

Fax

(573) 348-6767

NPI assigned

Jun 6, 2006

Organization subpart

No

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

Authorized official

Name

Susan Elaine Mitchell, C.PED

Title

Owner/Certified Pedorthist

Phone

(573) 348-6767

Specialties & licenses 1

Addresses

Other names 1

• Heavenly Soles Foot Comfort Center Doing business as

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699714592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 MAIN ST",
            "address_2": "SUITE B",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653033",
            "telephone_number": "573-348-6767",
            "fax_number": "573-348-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 MAIN ST",
            "address_2": "SUITE B",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653033",
            "telephone_number": "573-348-6767",
            "fax_number": "573-348-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN ELAINE MITCHELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "OWNER/CERTIFIED PEDORTHIST",
        "authorized_official_telephone_number": "573-348-6767",
        "authorized_official_credential": "C.PED"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heavenly Soles Foot Comfort Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brooke Elizabeth Stone, COTA/L
• Tasha Stuckenschneider
• Lee Supitilov
• William Supitilov
• Surgical Institute of Lake of the Ozarks LLC
• Lauren Elizabeth Taylor, OTR/L
• Jordan Alaine Teeple, MS, RD, LD
• The Lake'S Liver and Digestive Health Center Inc
• Kristen Anne Theobald-Hazel, DO
• Amy B Thompson, M.D.

• Prosthetic/Orthotic Supplier in Osage Beach, MO
• Providers in Osage Beach, MO by specialty
• Prosthetic/Orthotic Supplier in Missouri

• 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.