OrganizationActive
Lilburn Shoe Repair & Pedorthics Inc
NPI 1063564367 · Durable Medical Equipment & Medical Supplies · Lilburn, GA
Provider details
- NPI number
- 1063564367
- Entity type
- Organization
- Primary specialty
- Durable Medical Equipment & Medical SuppliesSuppliers
- Organization subpart
- No
- Authorized official
- Jackie Leandro, Owner(770) 931-0823
- License
- 9914 (GA)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4760 Lawrenceville Hwy Nw
Suite C-1
Lilburn, GA 30047-3858
Phone: (770) 931-0823
Street-level locationGet directions
Mailing address
2605 Sims Crest Ct
Snellville, GA 30078-4161
Other names (DBA / former)
- Former legal business name
- Lilburn Shoe Repair and Pedorthics Inc
- Former legal business name
- Lilburn Shoe Repair and Pedorthics Inc
Registry dates
- Enumerated
- 2007-01-17
- Last updated
- 2021-02-17
- Certified
- 2021-02-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.