Diabetic Shoe Clinic LLC

Key facts

NPI

1992598023

Entity type

Organization (NPI type 2)

Primary specialty

Durable Medical Equipment & Medical Supplies 332B00000X

Legal business name

DIABETIC SHOE CLINIC LLC

Practice address

2611 Greenbo Blvd
Flatwoods, KY 41139-1830

Phone

(606) 644-3815

NPI assigned

May 22, 2025

Organization subpart

No

Authorized official

Name

Shannon Kiser

Title

Owner

Phone

(606) 644-3815

National Provider Directory

Locations

Specialties & licenses

Addresses

Other names

• Diabetic Shoe Clinic Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 22, 2025.

{
    "created_epoch": "1747872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1992598023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 SPRING MEADOW DR",
            "city": "RADCLIFF",
            "state": "KY",
            "postal_code": "401609443",
            "telephone_number": "606-644-3815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 GREENBO BLVD",
            "city": "FLATWOODS",
            "state": "KY",
            "postal_code": "411391830",
            "telephone_number": "606-644-3815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETIC SHOE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-22",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A",
        "authorized_official_last_name": "KISER",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-644-3815"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diabetic Shoe Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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