KOOTENAI PROSTHETIC ORTHOTIC SERVICES INC (NPI# 1023379377) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023379377 |
| Entity Type | Organization |
| Organization Name | KOOTENAI PROSTHETIC ORTHOTIC SERVICES INC |
| Other Organization Name | KOOTENAI PROSTHETICS ORTHOTICS |
| Practice Address |
1160 E Polston Ave Post Falls ID 83854-6045 |
| Practice Telephone | 2084571545 |
| Practice Fax Number | 2084571659 |
| Mailing Telephone | 2084571545 |
| Mailing Fax Number | 2084571659 |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2015-09-25 |
| Authorized Official Name | MR. ROBERT A MILLER (PRESIDENT/CPO) |
| Authorized Official Telephone | 2084571545 |
| Authorized Official Credential | LCPO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| Other Name | Type Code |
|---|---|
| Kootenai Prosthetics Orthotics | Doing Business As Name - Organization |
| Street Address |
1160 E POLSTON AVE |
| City | POST FALLS |
| State | ID |
| Zip Code | 83854-6045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487264032 | Esteem Counseling, LLC | Counselor | 1404 North Marcasite Court, Post Falls, ID 83854 | 2020-08-07 |
| 1497376685 | Teresa Marie Ragan | Registered Nurse | 1551 E Mullan Ave Bldg A, Ste 200b, Post Falls, ID 83854 | 2020-04-29 |
| 1245792910 | Samantha Patricia Bourassa | Specialist/Technologist | 2832 E Poleline Ave, Post Falls, ID 83854 | 2019-04-02 |
| 1003392598 | Joshua Welz | Psychologist | 3211 N Guinness Ln Apt 201, Post Falls, ID 83854 | 2018-07-17 |
| 1639608094 | Anthony Leodis Walls Jr. | Specialist/Technologist | 8732 N Meyer Rd, Post Falls, ID 83854 | 2017-06-08 |
| 1831635911 | Glenda Felts | Social Worker | 8561 N Cloverleaf Rd, # 22, Hauser, ID 83854 | 2017-01-12 |
| 1144763467 | Rachel M. Pope | Behavioral Analyst | 204 E 1st Ave Apt 4, Post Falls, ID 83854 | 2016-11-18 |
| 1871960393 | Randy Robinson | Massage Therapist | 2525 E Seltice Way Ste C, Post Falls, ID 83854 | 2015-09-01 |
| 1194112375 | James Bailey | Family Medicine | 185 W 4th Ave Ste B, Post Falls, ID 83854 | 2015-04-24 |
| 1033534953 | Lauren Tandy | Speech-Language Pathologist | 398 S. Corbin Rd., Post Falls, ID 83854 | 2014-02-28 |
| Find all providers in zip 83854 | ||||
| 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 |
|---|---|---|---|---|
| 1881228591 | Idaho Prosthetics & Orthotics, Inc. | Prosthetic/Orthotic Supplier | 476 Cheney Dr W Ste 160, Twin Falls, ID 83301-3790 | 2020-03-03 |
| 1619508702 | Evergreen Prosthetics and Orthotics, LLC | Prosthetic/Orthotic Supplier | 1500 E Heritage Park St Ste 100, Meridian, ID 83646-5884 | 2020-01-28 |
| 1346803335 | Rehab Systems, Inc. | Prosthetic/Orthotic Supplier | 504 N 10th Ave Ste A, Caldwell, ID 83605-2925 | 2019-04-16 |
| 1588148134 | Dondell Inc. | Prosthetic/Orthotic Supplier | 2102 Caldwell Blvd Ste 116, Nampa, ID 83651-1513 | 2018-09-19 |
| 1598294811 | Ankle Roll Guard, LLC | Prosthetic/Orthotic Supplier | 560 W Ashby Dr, Meridian, ID 83646-4131 | 2017-06-08 |
| 1881126324 | Norco, Inc | Prosthetic/Orthotic Supplier | 163 Thula St Ste 6, Mccall, ID 83638-4429 | 2017-04-03 |
| 1861872269 | Orthopro of Twin Falls, Inc. | Prosthetic/Orthotic Supplier | 1200 Overland Ave, Suite 1, Burley, ID 83318-1867 | 2015-06-02 |
| 1881931319 | Occupational Therapy Unlimited, LLC | Prosthetic/Orthotic Supplier | 30 E Little Ave, Driggs, ID 83422-5138 | 2013-01-03 |
| 1427375724 | Performance Therapy, LLC | Prosthetic/Orthotic Supplier | 2922 Cortez Ave, Idaho Falls, ID 83404-7554 | 2010-04-26 |
| 1265756886 | Brownfields Inc | Prosthetic/Orthotic Supplier | 1912 E Franklin Rd, Meridian, ID 83642-5906 | 2010-03-25 |
| Find all providers with the same taxonomy | ||||
| City | POST FALLS |
| Zip Code | 83854 |
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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.