INNOVATIVE PROSTHETIC CARE TUPELO LLC (NPI# 1033499744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033499744 |
| Entity Type | Organization |
| Organization Name | INNOVATIVE PROSTHETIC CARE TUPELO LLC |
| Other Organization Name | INNOVATIVE PROSTHETIC CARE |
| Practice Address |
1714 N Gloster St Tupelo MS 38804-1216 |
| Mailing Address |
9034b Carl Legett Rd Gulfport MS 39503-6234 |
| Practice Telephone | 6628442202 |
| Practice Fax Number | 6015101610 |
| Mailing Telephone | 2286040818 |
| Mailing Fax Number | 2286040815 |
| Enumeration Date | 2011-08-25 |
| Last Update Date | 2013-02-21 |
| Authorized Official Name | MS. SHERYL S 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 |
|---|---|
| Innovative Prosthetic Care | Doing Business As Name - Organization |
| Street Address |
1714 N GLOSTER ST |
| City | TUPELO |
| State | MS |
| Zip Code | 38804-1216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356415244 | Gloster North Family Medical Clinic Inc | Nurse Practitioner | 1714 N Gloster St, Tupelo, MS 38804-1216 | 2006-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548874159 | Susan Me'chelle Oliver | Nurse Practitioner | 874 Barnes Crossing Road, Tupelo, MS 38804 | 2020-09-01 |
| 1134762784 | Kimberly J Adams | Occupational Therapy Assistant | 90 Clark Ave, Tupelo, MS 38804 | 2019-10-25 |
| 1790270924 | Megan Guntharp | Occupational Therapist | 960 Commonwealth Boulevard, Tupelo, MS 38804 | 2018-06-29 |
| 1154867562 | Urologic Ambulatory Surgery Center, LLC | Clinic/Center | 3353 N Gloster Street, Suite 300, Tupelo, MS 38804 | 2017-01-09 |
| 1790235919 | Dr Scott Dickinson D.m. D. PC | Dentist | 3999 N Gloster Street, Tupelo, MS 38804 | 2016-10-12 |
| 1326496621 | Angela Estes | Occupational Therapist | County Road 1279 House#197, Tupelo, MS 38804 | 2016-05-26 |
| 1316300080 | Eric Wade Tillotson | Family Medicine | 1665 South Green Street, Tupelo, MS 38804 | 2016-03-31 |
| 1104238898 | Stella M. Johnson | Social Worker | 2292 Camelot Cir, Tupelo, MS 38804 | 2014-05-29 |
| 1821437351 | Lenka Petersen | Student in an Organized Health Care Education/Training Program | 1665 S Green St., Nmmc, Tupelo, MS 38804 | 2013-06-18 |
| 1083966303 | Jessica M Baskett | Counselor | 398 E Main St, Tupelo, MS 38804 | 2012-10-10 |
| Find all providers in zip 38804 | ||||
| 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 |
|---|---|---|---|---|
| 1972923001 | John Smith | Prosthetic/Orthotic Supplier | 223 E Franklin St, Tupelo, MS 38804-4007 | 2014-04-16 |
| 1144244633 | Fitting Concepts Inc | Prosthetic/Orthotic Supplier | 130 S Industrial Rd, Tupelo, MS 38801-4614 | 2006-07-27 |
| 1396155826 | Ability Prosthetics,llc | Prosthetic/Orthotic Supplier | 223 E Franklin St, Tupelo, MS 38804-4007 | 2014-05-06 |
| 1073828190 | Complete Prosthetics & Orthotics Inc | Prosthetic/Orthotic Supplier | 797 S Gloster St, Tupelo, MS 38801-4903 | 2010-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962010645 | The Royal Studio | Prosthetic/Orthotic Supplier | 246 Briarwood Dr Ste 102, Jackson, MS 39206-3027 | 2020-07-17 |
| 1881219046 | Color Me Jazzy | Prosthetic/Orthotic Supplier | 665 S Pear Orchard Rd Ste 106-560, Ridgeland, MS 39157-4861 | 2020-06-13 |
| 1154945418 | Dream Hair Care | Prosthetic/Orthotic Supplier | 4401 W 4th St Ste E, Hattiesburg, MS 39402-1006 | 2020-06-02 |
| 1578186409 | Perfectly Imperfect Wig Collection | Prosthetic/Orthotic Supplier | 418 Carrollton Ave, Lexington, MS 39095-3212 | 2020-05-27 |
| 1366064263 | Lavishinglux Hair Imports | Prosthetic/Orthotic Supplier | 200 Belle Chasse Cir, Jackson, MS 39212-3164 | 2020-05-13 |
| 1275155749 | Fearless Beauty Company | Prosthetic/Orthotic Supplier | 611 S Pear Orchard Rd # 771, Ridgeland, MS 39157-4836 | 2020-05-07 |
| 1982225850 | Luxury Locs | Prosthetic/Orthotic Supplier | 4401 W 4th St Ste D, Hattiesburg, MS 39402-1006 | 2020-05-02 |
| 1518587914 | Bmb Medical Beautique | Prosthetic/Orthotic Supplier | 6515 Goodman Rd Ste 300, Olive Branch, MS 38654-7333 | 2020-04-26 |
| 1316567795 | Gyzele's Hair Boutique | Prosthetic/Orthotic Supplier | 1104 W Sunflower Rd, Cleveland, MS 38732-2440 | 2020-04-25 |
| 1083234462 | Shear Beauty 31 Hair Studio | Prosthetic/Orthotic Supplier | 665 S Pear Orchard Rd Ste 106-573, Ridgeland, MS 39157-4861 | 2020-04-25 |
| Find all providers with the same taxonomy | ||||
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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.