The Bootery, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

LPED.20 Issued in OH

Legal business name

THE BOOTERY, INC.

Doing business as

Bob Johns Family Shoes

Practice address

1400 Allentown Rd
Lima, OH 45805-2204

Phone

(419) 227-2829

Fax

(419) 227-7699

NPI assigned

Apr 20, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Robert Allen Johns, CERTIFIED PEDORTHISTNPI 1548560170

Title

President

Phone

(419) 227-2829

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bob Johns Family Shoes Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert A. Johns, LCPED

  • Pedorthist
  • Lima, OH
  • NPI 1548560170
  NPD Authorized official

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902023849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 ALLENTOWN RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458052204",
            "telephone_number": "419-227-2829",
            "fax_number": "419-227-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 ALLENTOWN RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458052204",
            "telephone_number": "419-227-2829",
            "fax_number": "419-227-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BOOTERY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-227-2829",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CERTIFIED PEDORTHIST"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "OH",
            "license": "LPED.20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0539706",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bob Johns Family Shoes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael David Terveer, D.D.S.
• Andrew Testa
• Gavitha Napathra Thabrew Wijeratne, MD
• Kristine Marie Thackrey, LISW, LICDC
• Amanda Thatcher, NP
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• Specialist in Lima, OH
• Providers in Lima, OH by specialty
• Specialist in Ohio

• 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.