Lake City Shoe Repair
NPI 1346629029 · Durable Medical Equipment & Medical Supplies · Coeur D Alene, ID
Enrolled with Medicare as Dme Supplier - Medical Supply Company With Pedorthic Personnel · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Lake City Shoe Repair is a Durable Medical Equipment & Medical Supplies organization in Coeur D Alene, ID (NPI 1346629029).
Provider details
- NPI number
- 1346629029
- Entity type
- Organization
- Primary specialty
- Durable Medical Equipment & Medical SuppliesSuppliers
- Organization subpart
- No
- Authorized official
- Wayne Johnson, Senior Partnor(208) 762-0797
- License
- NOT REQUIRED (ID)
Specialties & taxonomies
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 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
Mailing address
Other names (DBA / former)
- Other name
- Partnership
Registry dates
- Enumerated
- 2015-05-27
- Last updated
- 2015-11-12
Frequently asked questions
- What is Lake City Shoe Repair's NPI number?
- Lake City Shoe Repair's National Provider Identifier (NPI) is 1346629029, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lake City Shoe Repair?
- Lake City Shoe Repair is classified in the NPPES registry as Durable Medical Equipment & Medical Supplies (Suppliers).
- Where is Lake City Shoe Repair located?
- Lake City Shoe Repair's practice location on file with NPPES is 3115 N Government Way, Coeur D Alene, ID 83815-3790.
- What is Lake City Shoe Repair's phone number?
- The practice phone number listed in the NPPES registry for Lake City Shoe Repair is (208) 762-0797.
- Does Lake City Shoe Repair accept Medicare?
- Lake City Shoe Repair is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Lake City Shoe Repair?
- The authorized official listed on Lake City Shoe Repair's NPPES record is Wayne Johnson, Senior Partnor. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lake City Shoe Repair's NPI active?
- Yes — Lake City Shoe Repair's NPI (1346629029) is active in the NPPES registry as of the last update on 2015-11-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.