Jackrabbit Shoes and Orthotics, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

CPED 2916 Issued in CA

Legal business name

JACKRABBIT SHOES AND ORTHOTICS, INC.

Practice address

4576 E 2ND St
H
Benicia, CA 94510-1046

Phone

(707) 751-1630

Fax

(925) 226-3184

NPI assigned

Mar 18, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Dale SovakNPI 1518003243

Title

Owner

Phone

(707) 751-1630

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

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

• Dale Sovak, D.P.M., C.PED

  • Sports Medicine Podiatrist
  • Benicia, CA
  • NPI 1518003243
  NPD Authorized official

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

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300406400000",
    "number": "1982903720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4576 E 2ND ST",
            "address_2": "H",
            "city": "BENICIA",
            "state": "CA",
            "postal_code": "945101046",
            "telephone_number": "707-751-1630",
            "fax_number": "925-226-3184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4576 E 2ND ST",
            "address_2": "H",
            "city": "BENICIA",
            "state": "CA",
            "postal_code": "945101046",
            "telephone_number": "707-751-1630",
            "fax_number": "925-226-3184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKRABBIT SHOES AND ORTHOTICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-18",
        "last_updated": "2011-03-18",
        "status": "A",
        "authorized_official_last_name": "SOVAK",
        "authorized_official_first_name": "DALE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-751-1630",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "CA",
            "license": "CPED 2916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Innovative Health Solutions
• Integral Transit LLC
• Invisible Womb Holistic & Integrative Marriage & Family Therapy, Inc
• Irene Beissner MD Inc
• Heather Rashelle Isom, RADT
• Rachelle Jackson
• Alexandra Miriam Jansen, LMFT
• Lisa Ann Johnson, MA
• Therese Dale Jones-Garrett, M.F.T.
• Richard G. Joyce, O.D.

• Prosthetic/Orthotic Supplier in Benicia, CA
• Providers in Benicia, CA by specialty
• Prosthetic/Orthotic Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.