MEDSOURCE ORTHOTICS & PROSTHETICS (NPI# 1104968288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104968288 |
| Entity Type | Organization |
| Organization Name | MEDSOURCE ORTHOTICS & PROSTHETICS |
| Other Organization Name | HAMILTON PROSTHETIC CENTER |
| Practice Address |
14821 N Del Webb Blvd Suite 24 Sun City AZ 85351 |
| Mailing Address |
3636 N 3rd Ave Ste 100 Phoenix AZ 85013-3938 |
| Practice Telephone | 6238151001 |
| Practice Fax Number | 6238151441 |
| Mailing Telephone | 6023953354 |
| Mailing Fax Number | 6023953361 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2018-05-15 |
| Authorized Official Name | DAVID CHARLES (PRESIDENT) |
| Authorized Official Telephone | 8012555202 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDSOURCE ORTHOTICS & PROSTHETICS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| Other Name | Type Code |
|---|---|
| Hamilton Prosthetic Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275605461 | Medsource Orthotics & Prosthetics | Prosthetic/Orthotic Supplier | 9305 W. Thomas Rd, Suite 150, Phoenix, AZ 85037 | 2006-11-14 |
| Street Address |
14821 N DEL WEBB BLVD SUITE 24 |
| City | SUN CITY |
| State | AZ |
| Zip Code | 85351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700495892 | Modern Sports Medicine LLC | Preventive Medicine | 14821 N Del Webb Blvd, Sun City, AZ 85351-2145 | 2020-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467003566 | T&h Hearing LLC | Hearing Aid Equipment | 13616 N. 99th Ave., Sun City, AZ 85351 | 2019-09-20 |
| 1881247682 | Amanda M Neri | Physician Assistant | 10401 W. Thunderbird Blvd Md Anderson - Banner Boswell, Sun City, AZ 85351 | 2019-07-20 |
| 1649822313 | Azmed Rehab LLC | Family Medicine | 14281 North Del Webb Blvd, Sun City, AZ 85351 | 2019-07-12 |
| 1982182267 | Akdhc, LLC | Internal Medicine | 10249 W Thunderbird Blvd Ste 100, Sun City, AZ 85351 | 2018-07-30 |
| 1871084814 | Amy Mikulec | Physical Therapist | Banner Physical Therapy and Rehab Boswell, 10503 W Thunderbird Blvd Suite 263a, Sun City, AZ 85351 | 2018-05-25 |
| 1194238345 | Lorie Jo Matthews | Nurse Practitioner | 10494 W Thunderbird Blvd Ste 102, Sun City, AZ 85351 | 2017-11-09 |
| 1184153363 | Susan Jane Hockman | Registered Nurse | 14601 N Delwebb Blvd, Sun City, AZ 85351 | 2017-06-09 |
| 1043769169 | Medsource Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 13203 N 103rd Ave Ste J1&j2, Sun City, AZ 85351 | 2016-09-30 |
| 1033563002 | Vittoria Giovannucci | Technician/Technologist | 10503 W Thunderbird Blvd Ste 101a, Sun City, AZ 85351 | 2016-04-15 |
| 1669858379 | Qui Nguyen | Pharmacist | 10660 Nw Grand Ave, Sun City, AZ 85351 | 2015-08-04 |
| Find all providers in zip 85351 | ||||
| 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 |
|---|---|---|---|---|
| 1043769169 | Medsource Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 13203 N 103rd Ave Ste J1&j2, Sun City, AZ 85351 | 2016-09-30 |
| 1720253305 | Core Prosthetics Lab, Inc. | Prosthetic/Orthotic Supplier | 29723 New Hub Dr Ste A, Sun City, CA 92586-6537 | 2008-04-24 |
| 1538484548 | Southwestern Eye Center Ltd | Prosthetic/Orthotic Supplier | 10615 W. Thunderbird, Bldg. A100, Sun City, AZ 85351-3018 | 2010-04-01 |
| 1568593325 | Banner Arizona Medical Clinic Ltd | Prosthetic/Orthotic Supplier | 10401 W Thunderbird Blvd, Ste 209, Sun City, AZ 85351-3004 | 2007-03-07 |
| 1013975929 | Team O'neill Inc | Prosthetic/Orthotic Supplier | 10336 W Coggins Dr, Suite B, Sun City, AZ 85351-3438 | 2006-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851916217 | Bionic Prosthetics and Orthotics Group LLC | Prosthetic/Orthotic Supplier | 633 E Ray Rd Ste 111, Gilbert, AZ 85296-4202 | 2020-06-11 |
| 1285258996 | Mobility Prosthetic and Orthotic Services LLC | Prosthetic/Orthotic Supplier | 1921 Motor Ave Ste B, Kingman, AZ 86401-4185 | 2020-05-29 |
| 1083254528 | Active Life Orthotics and Prosthetics Corp | Prosthetic/Orthotic Supplier | 3811 E Bell Rd Ste 112, Phoenix, AZ 85032-2158 | 2020-01-13 |
| 1487291688 | Nevada Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 1863 Airfied Avenue, Kingman, AZ 86401-4004 | 2019-12-06 |
| 1841857596 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 7330 N 99th Ave Ste 225, Glendale, AZ 85307-3003 | 2019-05-28 |
| 1992362370 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 6373 E Tanque Verde Rd Ste 140, Tucson, AZ 85715-3835 | 2019-05-21 |
| 1629539275 | Capitol Orthopedic Inc | Prosthetic/Orthotic Supplier | 4001 N 3rd St Ste 405, Phoenix, AZ 85012-2065 | 2019-03-27 |
| 1245724822 | Medsource Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 1450 S Dobson Rd Ste B326, Mesa, AZ 85202 | 2018-06-18 |
| 1184133191 | Lumin Enterprises | Prosthetic/Orthotic Supplier | 15207 N 75th St Ste 111, Scottsdale, AZ 85260-2445 | 2017-09-21 |
| 1942727250 | Ideal Health Care, L.L.C. | Prosthetic/Orthotic Supplier | 1675 Mesquite Ave Ste A, Lake Havasu City, AZ 86403 | 2017-08-28 |
| 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.