Scioto Shoe Mart Inc

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

SCIOTO SHOE MART INC

Practice address

206 James Way
Marion, OH 43302-5818

Phone

(740) 389-5775

Fax

(740) 389-1269

NPI assigned

Jul 22, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Shannon Lee Stark, CERTIFIED PEDORTHIST

Title

Manager/ C.Ped

Phone

(740) 389-5775

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248825600000",
    "number": "1932364668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 JAMES WAY",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433025818",
            "telephone_number": "740-389-5775",
            "fax_number": "740-389-1269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 JAMES WAY",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433025818",
            "telephone_number": "740-389-5775",
            "fax_number": "740-389-1269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCIOTO SHOE MART INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-22",
        "last_updated": "2009-07-29",
        "status": "A",
        "authorized_official_last_name": "STARK",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "MANAGER/ C.PED",
        "authorized_official_telephone_number": "740-389-5775",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CERTIFIED PEDORTHIST"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Ruth Schwaderer, LPN
• Keystan Schwaderer, QMHS, CMS
• Paxton N. Schwaderer, CRNA
• Ashley Schwartz, LSW
• Kymberleigh Schwemley
• Barbara Ann Scott-Johnson, PH.D.
• SD Cardiothoracic Services, Inc.
• Kim Seese, O.T.
• Kaitlyn Seiter
• Rebecca Seitter

• Customized Equipment (DME) in Marion, OH
• Providers in Marion, OH by specialty
• Customized Equipment (DME) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2009; 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.