SOUTHERN PROSTHETIC CARE LLC (NPI# 1205352127) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205352127 |
| Entity Type | Organization |
| Organization Name | SOUTHERN PROSTHETIC CARE LLC |
| Practice Address |
4201 Highway 11 N Ste D Picayune MS 39466 |
| Mailing Address |
4201 Highway 11 N Ste D Picayune MS 39466-2014 |
| Practice Telephone | (228) 216-0528 |
| Practice Fax Number | 7692422556 |
| Mailing Telephone | 2282160528 |
| Mailing Fax Number | 7692422556 |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2018-05-15 |
| Authorized Official Name | WILLIAM J KENNY (OWNER) |
| Authorized Official Telephone | 2282160528 |
| Authorized Official Credential | CP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063050862 | Southern Prosthetic Care LLC | Prosthetic/Orthotic Supplier | 1308 44th Ave, Gulfport, MS 39501-2552 | 2019-12-12 |
| Street Address |
4201 HIGHWAY 11 N STE D |
| City | PICAYUNE |
| State | MS |
| Zip Code | 39466 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750833786 | William J. Kenny | Orthotist | 4201 Highway 11 N Ste D, Picayune, MS 39466-2014 | 2016-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295270684 | Ashley Royerre Talley | Speech-Language Pathologist | 621 W Canal St, Picayune, MS 39466 | 2016-12-21 |
| 1306396213 | Kathy English | Counselor | 102 Roy St, Picayune, MS 39466 | 2016-10-04 |
| 1124379631 | Hancock Medical Health Services, Inc. | Nurse Practitioner | 23350 Highway 43, Picayune, MS 39466 | 2012-09-24 |
| 1578876280 | Joy A. Weidemann | Social Worker | 120 Street A Ste C, Picayune, MS 39466 | 2010-07-22 |
| 1407188477 | Picayune School District | Local Education Agency (LEA) | 706 Goodyear Blvd., Picayune, MS 39466 | 2010-02-02 |
| 1164751079 | Picayune School District Early Head Start | Early Intervention Provider Agency | 1620 Rosa St, Picayune, MS 39466 | 2009-12-24 |
| 1124352505 | Stephanie Deanne Farrell | Speech-Language Pathologist | 201 E. Second Street, Picayune, MS 39466 | 2009-10-01 |
| 1902084007 | Ludwick L Lohnes Dc LLC | Chiropractor | 214 Norwood Street, Picayune, MS 39466 | 2008-01-31 |
| 1932395878 | Prohealth Solutions, Inc | Occupational Therapist | 722 West Canal Street, Picayune, MS 39466 | 2007-09-24 |
| 1669677431 | Terri L Bordelon | Social Worker | 214 N Curran, Suite A, Picayune, MS 39466 | 2007-06-20 |
| Find all providers in zip 39466 | ||||
| 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 |
|---|---|---|---|---|
| 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.