PROSTHETIC LABORATORIES OF ROCHESTER, INC. (NPI# 1013322650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013322650 |
| Entity Type | Organization |
| Organization Name | PROSTHETIC LABORATORIES OF ROCHESTER, INC. |
| Other Organization Name | HANGER CLINIC |
| Practice Address |
3835 Supreme Ct Nw Suite 4 Bemidji MN 56601-4446 |
| Mailing Address |
Po Box 650846 Dallas TX 75265-0846 |
| Practice Telephone | 2188257255 |
| Practice Fax Number | 5076258564 |
| Mailing Telephone | 2188257255 |
| Mailing Fax Number | 5076258564 |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2015-12-10 |
| Authorized Official Name | SHERYL PRICE (DIRECTOR OF REIMBURSEMENT) |
| Authorized Official Telephone | 5034938288 |
| Is Organization Subpart | Y |
| Parent Organization Name | HANGER INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| Other Name | Type Code |
|---|---|
| Hanger Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164685475 | Prosthetic Laboratories of Rochester, Inc. | Prosthetic/Orthotic Supplier | 831 Critter Ct, Suite 300, Onalaska, WI 54650-8674 | 2008-07-07 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PROSTHETIC LABORATORIES OF ROCHESTER, INC. | 221 W Madison St Ste 7, Eau Claire, WI 54703-4412 |
| Street Address |
3835 SUPREME CT NW SUITE 4 |
| City | BEMIDJI |
| State | MN |
| Zip Code | 56601-4446 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831325620 | Choice Therapy, P.a. | Physical Therapist | 3835 Supreme Ct Nw, Bemidji, MN 56601-4446 | 2009-06-07 |
| 1649720400 | Choice Therapy | Clinic/Center | 3835 Supreme Ct Nw, Bemidji, MN 56601-4446 | 2016-10-05 |
| 1417402637 | Andrew Kremer | Physical Therapist | 3835 Supreme Ct Nw, Bemidji, MN 56601-4446 | 2016-08-17 |
| 1114378742 | Kirsten Landmark | Speech-Language Pathologist | 3835 Supreme Ct Nw, Suite 2, Bemidji, MN 56601-4446 | 2016-06-24 |
| 1538537618 | Marlee Westrum | Occupational Therapist | 3835 Supreme Ct Nw, Suite 2, Bemidji, MN 56601-4446 | 2015-09-08 |
| 1700278306 | Roberta Erickson | Occupational Therapist | 3835 Supreme Ct Nw, Bemidji, MN 56601-4446 | 2015-02-19 |
| 1467856799 | Brady Miller | Physical Therapist | 3835 Supreme Ct Nw, Suite 2, Bemidji, MN 56601-4446 | 2014-10-15 |
| 1831510668 | Kelly Dunsmore | Physical Therapist | 3835 Supreme Ct Nw, #2, Bemidji, MN 56601-4446 | 2013-12-20 |
| 1700215035 | Erin Millicent Wark May | Speech-Language Pathologist | 3835 Supreme Ct Nw, Suite 2, Bemidji, MN 56601-4446 | 2013-11-07 |
| 1316380850 | Chantel Justina Wickham | Physical Therapist | 3835 Supreme Ct Nw, #2, Bemidji, MN 56601-4446 | 2013-04-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772425 | Northern Minnesota Addiction Wellness Center | Substance Abuse Rehabilitation Facility | 4851 Stacy Ann Dr Nw, Bemidji, MN 56601 | 2020-02-17 |
| 1366093841 | Vickie Lynn Matthews | Technician | 1018 Miles Ave Se, Bemidji, MN 56601 | 2019-09-25 |
| 1518443530 | Lindsey Marie Whiting | Registered Nurse | 1300 Anne St, Bemidji, MN 56601 | 2018-07-12 |
| 1801257662 | Meghan Zigrida Paquette | Registered Nurse | 6055 161st Street Nw, Cass Lake, MN 56601 | 2016-03-08 |
| 1144686106 | Northwest Indian Oic | Home Health | 1819 Bemidji Ave N Ste 1, Bemidji, MN 56601 | 2016-01-06 |
| 1831560424 | Laura Hansen, Msw, Licsw Counseling Services, Inc. | Social Worker | 403 4th Street Ne, Suite 110, Bemidji, MN 56601 | 2015-10-08 |
| 1679949028 | Grand St. Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 2312 Bemidji Ave North, Bemidji, MN 56601 | 2015-08-19 |
| 1255717617 | Mary S. Salter, Md Psc | Internal Medicine | 514 Beltrami Ave Nw Suite 102, Bemidji, MN 56601 | 2015-08-07 |
| 1225420615 | Cristin Evans | Counselor | 403 4th Street, Suite 300, Bemidji, MN 56601 | 2015-02-23 |
| 1619367919 | Angela Krom Fournier | Psychologist | 16150 Golden Eagle Court Nw, Eagle Vista Equine Center Inc., Bemidji, MN 56601 | 2015-01-26 |
| Find all providers in zip 56601 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| 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. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427234681 | Prosthetic Laboratories of Rochester, Inc | Prosthetic/Orthotic Supplier | 1300 Anne St Nw, Bemidji, MN 56601-5103 | 2008-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578648 | Kanika Lanese Baker | Prosthetic/Orthotic Supplier | 7240 Brooklyn Blvd Ste 150, Brooklyn Park, MN 55429-1274 | 2020-11-05 |
| 1932758067 | David Allen Young | Prosthetic/Orthotic Supplier | 1163 Wayzata Blvd E, Wayzata, MN 55391-1935 | 2019-09-11 |
| 1073080230 | Rebound Orthotics & Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 2805 Campus Dr Ste 101, Plymouth, MN 55441-2676 | 2018-10-25 |
| 1760998165 | Abilitech Medical, Inc. | Prosthetic/Orthotic Supplier | 628 Pine St, Saint Paul, MN 55130-4421 | 2017-12-20 |
| 1003351990 | Arise Orthotics & Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 8338 Highway 65 Ne, Suite E, Spring Lake Park, MN 55432-1364 | 2016-12-30 |
| 1073065298 | Language of Hair | Prosthetic/Orthotic Supplier | 1615 London Rd, Duluth, MN 55812-1620 | 2016-11-04 |
| 1275900664 | Nordstrom Inc & Subsidiaries | Prosthetic/Orthotic Supplier | 12401 Wayzata Blvd, Minnetonka, MN 55305-1974 | 2015-09-01 |
| 1326483264 | Prosthetic Specialties LLC | Prosthetic/Orthotic Supplier | 13143 Lake Place Rd, Zimmerman, MN 55398-9567 | 2013-05-06 |
| 1427300706 | Rebound Orthotics & Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 1073 Highway 15 S, Plaza 15, Hutchinson, MN 55350-3153 | 2012-10-10 |
| 1033461322 | Rebound Orthotics & Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 300 Catlin St Ste 104, Buffalo, MN 55313-2035 | 2012-10-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.