BACK BRACE SUPPLY LLC (NPI# 1225679277) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1225679277 |
Entity Type | Organization |
Organization Name | BACK BRACE SUPPLY LLC |
Practice Address |
670 S White Station Rd Memphis TN 38117-4527 |
Practice Telephone | 9016192297 |
Mailing Telephone | 9016192297 |
Mailing Fax Number | 9017632909 |
Enumeration Date | 2019-10-01 |
Last Update Date | 2020-11-05 |
Authorized Official Name | DANA HUNTER PASCHAL (OWNER) |
Authorized Official Telephone | 9016192297 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Street Address |
670 S WHITE STATION RD |
City | MEMPHIS |
State | TN |
Zip Code | 38117-4527 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154980639 | Zup Medical Services, LLC | Clinic/Center | 4576 Poplar Avenue, Memphis, TN 38117 | 2019-06-10 |
1104386028 | Faith Christie Leigh Roby | Counselor | 4646 Poplar Ave Ste 510, Memphis, TN 38117 | 2019-03-25 |
1023511300 | Genita Lashonda Johnson-hammond | Specialist | 4565 Quince Rd, 1b, Memphis, TN 38117 | 2018-03-14 |
1023547494 | Rivka R Braverman | Licensed Practical Nurse | 5050 Sanderlin Avenue, Memphis, TN 38117 | 2017-06-08 |
1285002451 | Shauna Lomax | Physical Therapy Assistant | 258 Leonora Dr, Memphis, TN 38117 | 2015-09-04 |
1255735569 | Caring Hearts of The Mid South | In Home Supportive Care | 4646 Poplar, Suite 213b, Memphis, TN 38117 | 2014-10-15 |
1063821296 | Tomasz A Charowski | Dentist | 670 Colonial Rd Ste 3, Memphis, TN 38117 | 2014-08-13 |
1255760385 | Tennessee Dental Professionals PC | Dentist | 370 Colonial Road, 3, Memphis, TN 38117 | 2013-11-08 |
1447692264 | Dory Sellers | Dentist | 4515 Poplar Avenue, Suite 406, Memphis, TN 38117 | 2013-07-22 |
1366791808 | Amirio Jonte Armour | Pharmacist | 1760 Moriah Woods, Suite 2, Memphis, TN 38117 | 2012-08-30 |
Find all providers in zip 38117 |
Taxonomy Code | 225000000X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Orthotic Fitter |
An individual trained in the management of fitting prefabricated orthoses. |
Notes: Source: National Uniform Claim Committee [1/1/2011: title modified, definition modfied] 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 |
---|---|---|---|---|
1487962726 | Gary Kent Weaver Jr. | Orthotic Fitter | 348 Trane Dr, Knoxville, TN 37919-6052 | 2010-09-21 |
1609075621 | Bobijo Murphy | Orthotic Fitter | 1238 Nw Broad St, Murfreesboro, TN 37129-1713 | 2007-07-11 |
1548305501 | Norma Jean Johnson | Orthotic Fitter | 140 Lake Dr., Tiptonville, TN 38079-1359 | 2007-02-20 |
1598797045 | Breast Prostheses & Orthotics Inc | Orthotic Fitter | 1850 Edgemont Ave, Bristol, TN 37620-4309 | 2006-07-07 |
1336148808 | Diana Lynn Montgomery | Orthotic Fitter | 60 Long Ave, Parsons, TN 38363-2429 | 2005-07-18 |
1942780580 | Matthew D Stimson | Orthotic Fitter | 2435 Jacksboro Pike Ste 3, La Follette, TN 37766-2912 | 2018-08-14 |
1073815999 | Wendy D Eaton | Orthotic Fitter | 2150 N Ocoee St, Cleveland, TN 37311-3936 | 2010-11-29 |
1821274713 | Penny G Handmacher | Orthotic Fitter | 2030 Chilhowee Medical Park, Maryville, TN 37804-5285 | 2008-01-10 |
1942498712 | Scott Moore | Orthotic Fitter | 705 N 2nd St, Suite A, Clarksville, TN 37040-1917 | 2007-10-05 |
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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.