Chuck's Foot Support

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

1954 Issued in DE

Legal business name

CHUCK'S FOOT SUPPORT

Practice address

4546 Maplecrest Rd
Fort Wayne, IN 46835-3970

Phone

(260) 492-1752

Fax

(260) 492-1752

NPI assigned

Dec 27, 2010

Last updated

Dec 27, 2010By 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. Charles A Bolinger, C.PEDNPI 1073789954

Title

LLC Owner

Phone

(260) 492-1752

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles Arthur Bolinger, CPED

  • Other Technician
  • Fort Wayne, IN
  • NPI 1073789954
  NPD (past) Authorized official

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

{
    "created_epoch": "1293408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293408000000",
    "number": "1760786222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4546 MAPLECREST RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468353970",
            "telephone_number": "260-492-1752",
            "fax_number": "260-492-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4546 MAPLECREST RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468353970",
            "telephone_number": "260-492-1752",
            "fax_number": "260-492-1752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHUCK'S FOOT SUPPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-27",
        "last_updated": "2010-12-27",
        "status": "A",
        "authorized_official_last_name": "BOLINGER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "LLC OWNER",
        "authorized_official_telephone_number": "260-492-1752",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "C.PED"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "DE",
            "license": "1954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Beth Christopher, DPT
• Jonathan Christophersen, CRNA
• Mary Casey Christophersen, NP
• Dennis John Chubinski, D.P.M.
• Chuck Howie Counseling Services, PC
• Catherine S. Chung, M.D.
• Ann Chupp
• Gregory L Chupp, MD
• William Churchill-Brooks
• Emily Cicero, RD

• Customized Equipment (DME) in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Customized Equipment (DME) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2010; 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.