BLUE MOON SHOES
NPI 1558539338
Prosthetic/Orthotic Supplier in Warsaw, IN

Q: What is Lisa E Rostvold's NPI number?

The NPI number for Lisa E Rostvold is 1558539338. It was assigned to this organization in the NPPES registry on February 14, 2008. The provider is doing business as Blue Moon Shoes.

Q: What is Lisa E Rostvold's specialty?

The primary specialty registered for this NPI is Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.

Q: When was this NPI record last updated?

The NPPES record for Lisa E Rostvold was last updated on June 19, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 14, 2008

110 N BUFFALO ST, WARSAW, IN 46580(574) 267-5537(574) 267-6165 Get Directions Write a Review

NPPES record last updated: June 19, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Blue Moon Shoes NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLUE MOON SHOES (NPI 1558539338) is a healthcare organization registered as a prosthetic/orthotic supplier in Warsaw, Indiana and active in the NPI registry since February 2008. The organization lists Lisa Ellen Rostvold, Owner, as its authorized official.

NPPES Registry Identity

NPI1558539338

Entity TypeOrganization

Primary Taxonomy335E00000X

Legal Business NameLISA E ROSTVOLD

Location Address110 N BUFFALO STWarsaw, IN 46580-2754

Mailing Address110 N Buffalo StWarsaw, IN 46580-2754 · (574) 267-5537 · Fax (574) 267-6165

Phone(574) 267-5537

Fax(574) 267-6165

Organization SubpartNo

Authorized OfficialLisa Ellen RostvoldOwner · (574) 267-5537

Enumeration DateFebruary 14, 2008

Last NPPES UpdateJune 19, 2008

✔ NPI 1558539338 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyProsthetic/Orthotic SupplierSuppliers

Taxonomy Code335E00000X

License✔ Licensed in IN · CPED2624

Definition

An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.

110 N BUFFALO ST, Warsaw, IN 46580

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Other Names 1

Doing Business AsBlue Moon Shoes

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lisa E Rostvold's NPI number?

The NPI number for Lisa E Rostvold is 1558539338. It was assigned to this organization in the NPPES registry on February 14, 2008. The provider is doing business as Blue Moon Shoes.

Where is Lisa E Rostvold located?

Lisa E Rostvold is located at 110 N Buffalo St, Warsaw, IN 46580. The listed phone number is (574) 267-5537.

What is Lisa E Rostvold's specialty?

The primary specialty registered for this NPI is Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.

When was this NPI record last updated?

The NPPES record for Lisa E Rostvold was last updated on June 19, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.