LESTERS DIABETIC SHOE SERV — NPI 1790900249 (Licensed & Credentialed Assistant, Podiatric in ESTILL, SC)

CMS-1500 Box 24J / 33a • NPI

1790900249

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

211D00000X

Licensed & Credentialed Assistant, Podiatric

Box 32 Service Location & ZIP+4

41 BLAIR CIRCLE, ESTILL, SC, 29918

Official NPPES Practice Location

Practice Phone & Referral Fax

(803) 625-4100

Fax: (803) 625-4100

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1790900249 (LESTERS DIABETIC SHOE SERV) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1790900249` (NPI-2 Organization / Facility)
Provider / Legal Name	LESTERS DIABETIC SHOE SERV
Plain-English Specialty	Licensed & Credentialed Assistant, Podiatric NUCC Code: `211D00000X` (Assistant, Podiatric)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	41 BLAIR CIRCLE, ESTILL, SC, 29918
Practice Telephone / Fax	Tel: (803) 625-4100 \| Fax: (803) 625-4100
Administrative Mailing Address	PO BOX 632, ESTILL, SC, 29918
Enumeration & Last Sync	Enumerated: 2007-04-17 \| CMS Record Updated: 2008-07-24
Authorized Official	ETHEL DANDY (Pedorthic Owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

41 BLAIR CIRCLE, ESTILL, SC, 29918

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Plain-English Taxonomy & CMS Crosswalk (211D00000X)

What Does Taxonomy Code 211D00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 211D00000X translates to:
"Licensed & Credentialed Assistant, Podiatric"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Assistant, Podiatric for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (LESTERS DIABETIC SHOE SERV)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`332B00000X` — Durable Medical Equipment & Medical Supplies Plain English: Licensed & Credentialed Suppliers — Durable Medical Equipment & Medical Supplies	State: SC \| License: `Verified` \| Primary: Secondary
`335E00000X` — Prosthetic/Orthotic Supplier Plain English: Licensed & Credentialed Suppliers — Prosthetic — Orthotic Supplier	State: SC \| License: `Verified` \| Primary: Secondary
`211D00000X` — Assistant, Podiatric Plain English: Licensed & Credentialed Assistant, Podiatric	State: SC \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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LESTERS DIABETIC SHOE SERV (NPI #1790900249)