Footwear by Design

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

PED154 Issued in FL

Legal business name

FOOTWEAR BY DESIGN

Practice address

1967 Longwood Lake Mary Rd
Suite 1001
Longwood, FL 32750-4673

Phone

(407) 323-7441

Fax

(407) 323-1964

NPI assigned

Feb 7, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Pamela Ann Eckenrode, L.C.PED

Title

Owner

Phone

(407) 323-7441

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236297600000",
    "number": "1962542019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1967 LONGWOOD LAKE MARY RD",
            "address_2": "SUITE 1001",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504673",
            "telephone_number": "407-323-7441",
            "fax_number": "407-323-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1967 LONGWOOD LAKE MARY RD",
            "address_2": "SUITE 1001",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504673",
            "telephone_number": "407-323-7441",
            "fax_number": "407-323-1964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTWEAR BY DESIGN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2009-03-06",
        "status": "A",
        "authorized_official_last_name": "ECKENRODE",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-323-7441",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "L.C.PED"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "PED154",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "FL",
            "license": "PED154",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.