LODI PODIATRY GROUP NPI 1750360699

NPI Information

  • NPI: 1750360699
  • Provider Name: LODI PODIATRY GROUP
  • Classification: Podiatrist - 213E00000X
  • Entity Type: Organization
  • Other Name: SHOCK THOMAS GEN PTR
  • Address: 1300 W LODI AVE
    STE W
    LODI, CA
    ZIP 95242
  • Phone: (209) 334-6664

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NPI Details

LODI PODIATRY GROUP is a podiatrist in Lodi, CA. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. LODI PODIATRY GROUP NPI is 1750360699. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Shock Thomas Gen Ptr.

The provider's business location address is:

1300 W LODI AVE
STE W
LODI, CA
ZIP 95242-038
Phone: (209) 334-6664
Fax: (209) 334-2379

The provider's authorized official is Kerry Lyn Myers .
The authorized official title is Office Manager and has the following contact phone number (209) 334-0429.

The enumeration date for this NPI number is 1/10/2006 and was last updated on 11/12/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213E00000XPodiatristE3241CALIFORNIANo
2213ER0200XPodiatristRadiologyE3241CALIFORNIANo
3213ER0200XPodiatristRadiologyE3467CALIFORNIANo
4213ES0103XPodiatristFoot & Ankle SurgeryE3241CALIFORNIANo
5213ES0103XPodiatristFoot & Ankle SurgeryE3467CALIFORNIANo
6213E00000XPodiatristE3467CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1000E34670MEDICAIDCALIFORNIA
2000E32410MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIASHOCK'S M/CARE #
3000E32410MEDICAIDCALIFORNIA
4T11594MEDICARE UPINCALIFORNIA
5T90634MEDICARE UPINCALIFORNIA
6000E34670MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIASTROH'S M/CARE #
70841340001MEDICARE NSCCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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