The Doctors Shoe Store

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

121954071029341 Issued in FL

Legal business name

THE DOCTORS SHOE STORE

Practice address

1228 SE Port St Lucie Blvd
Port St Lucie, FL 34952-5330

Phone

(772) 380-9998

NPI assigned

Dec 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Russell Miles Blatstein, DPM

Title

Owner

Phone

(772) 380-9998

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790846020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1228 SE PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525330",
            "telephone_number": "772-380-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1228 SE PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525330",
            "telephone_number": "772-380-9998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DOCTORS SHOE STORE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLATSTEIN",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "MILES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-380-9998",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "121954071029341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "R9845",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kamla Thakor-Rice
• The ABA Loft
• The Access Couture, PLLC
• The Calminground LLC
• The Colonnades Group Home, Inc
• The Gift House, Inc
• The Gift of Recovery, LLC
• The House of Cares Inc
• The Inner Truth Project
• The Loving Care Home LLC

• Durable Medical Equipment & Medical Supplies in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• 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.