NPI age
10 years
Enumerated 2015-05-27
● Active Type 2 · Organization
Lake City Shoe Repair
Lake City Shoe Repair is 1 of 264 durable medical equipment & medical supplies organizations in Idaho.
Primary specialty
Durable Medical Equipment & Medical Supplies
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Johnson
Senior Partnor
Last NPPES update
2015-11-12
Source: monthly bulk 2026-05
How this organization compares
Across 264 active durable medical equipment & medical supplies providers in Idaho.
NPI age
10 years
↓ 7 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2015 → 2026
2015-05Enumerated in NPPES
2015
2026
Where they practice
Primary practice location
3115 N Government Way, #7
Coeur D Alene, ID 838153790
Mailing address
3115 N Government Way, #7
Coeur D Alene, ID 838153790
Authorized official
Wayne C Johnson, CPED
Senior Partnor
📞 2087620797
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Ruth Frantz, CERT. ACUPUNCTURIST Acupuncturist NPI 1821217290
Specialties
-
Durable Medical Equipment & Medical Supplies PrimaryA supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 5127610001 | PTAN |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
PARTNERSHIP
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.