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Lake City Shoe Repair

Durable Medical Equipment & Medical Supplies in Coeur D Alene, ID · enumerated 2015 · authorized official Wayne Johnson, Senior Partnor.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1346629029

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Registry record

Entity type Organization (Type 2)
Legal business name Lake City Shoe Repair
Other name <Unavail>
Practice address 3115 N Government Way, #7, Coeur D Alene, ID, 83815
Phone (208) 762-0797
Fax (208) 762-0791
Enumeration date May 27, 2015
Last updated in NPPES Nov 12, 2015

Taxonomy & classification

332B00000X Durable Medical Equipment & Medical Supplies Suppliers · License NOT REQUIRED (ID) Primary

Authorized official

Name Wayne Johnson
Title Senior Partnor
Phone (208) 762-0797

Other identifiers

Identifier Type State Issuer
5127610001 Other ID PTAN

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2015-11-12. Verify at npiregistry.cms.hhs.gov.
Where is Lake City Shoe Repair located?
The practice location on file with NPPES is in Coeur D Alene, ID.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2015-11-12.