Organization Active NPI

Feet 1St Shoes, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
National Provider Identifier
1902986748
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
PED69 Issued in FL
Legal business name
FEET 1ST SHOES, INC.
Practice address
8081 Philips Hwy
Suite 5
Jacksonville, FL 32256-7464
Phone
(904) 731-3338
Fax
(904) 731-3348
NPI assigned
Oct 16, 2006
Last updated
Sep 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Authorized official

Name
Mr. Wade Nield, C.PED.
Title
President
Phone
(904) 731-3338

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X PED69 FL Primary

Addresses

Primary practice location

8081 Philips Hwy
Suite 5
Jacksonville, FL 32256-7464

Mailing address

8081 Philips Hwy Ste 4
Jacksonville, FL 32256-7443
Phone (904) 731-3338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930041817 FL DME Supplier - Medical Supply Company With Pedorthic Personnel 3779796362 Practice locations: Jacksonville, FL

National Provider Directory

National Provider Directory

Locations

8081 Philips Hwy
Ste 4
Jacksonville, FL 32256
Phone (904) 731-3338

8081 Philips Hwy
Ste 5
Jacksonville, FL 32256
Phone (904) 872-3100

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631059200000",
    "number": "1902986748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8081 PHILIPS HWY STE 4",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567443",
            "telephone_number": "904-731-3338",
            "fax_number": "904-731-3348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8081 PHILIPS HWY",
            "address_2": "SUITE 5",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567464",
            "telephone_number": "904-731-3338",
            "fax_number": "904-731-3348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FEET 1ST SHOES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A",
        "authorized_official_last_name": "NIELD",
        "authorized_official_first_name": "WADE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-731-3338",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "C.PED."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "PED69",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.