Organization Active NPI

Vagabond Shoes, Inc.

  • Prosthetic/Orthotic Supplier
  • Appleton, WI
National Provider Identifier
1861407561
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
VAGABOND SHOES, INC.
Practice address
4760 Integrity Way
Appleton, WI 54913-8464
Phone
(920) 882-3989
Fax
(920) 882-3988
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kathleen M Kelnhofer
Title
Owner
Phone
(920) 606-0163

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X WI Primary

Addresses

Primary practice location

4760 Integrity Way
Appleton, WI 54913-8464

Mailing address

1243 Beechwood CT
Green Bay, WI 54313-7261
Phone (920) 606-0163

National Provider Directory

National Provider Directory
Tax ID family
Vagabond Shoes Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4760 W Integrity Way
Appleton, WI 54913
Phone (920) 882-3989

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861407561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1243 BEECHWOOD CT",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543137261",
            "telephone_number": "920-606-0163",
            "fax_number": "920-882-3988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 INTEGRITY WAY",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138464",
            "telephone_number": "920-882-3989",
            "fax_number": "920-882-3988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAGABOND SHOES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELNHOFER",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-606-0163"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • 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.