PROSTHETIC SPECIALTIES LLC (NPI# 1326483264) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326483264 |
| Entity Type | Organization |
| Organization Name | PROSTHETIC SPECIALTIES LLC |
| Practice Address |
13143 Lake Place Rd Zimmerman MN 55398-9567 |
| Practice Telephone | 7636073372 |
| Mailing Telephone | 7636073372 |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2013-05-06 |
| Authorized Official Name | BRET DOUGLAS RECKINGER (PRESIDENT) |
| Authorized Official Telephone | 7636073372 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| Street Address |
13143 LAKE PLACE RD |
| City | ZIMMERMAN |
| State | MN |
| Zip Code | 55398-9567 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033206750 | Pine Ridge Dental Pa | Dentist | 26273 2nd St E, Suite A, Zimmerman, MN 55398 | 2006-10-06 |
| 1699850826 | Steven R Luginbill | Chiropractor | 26273 2nd St E, Zimmerman, MN 55398 | 2006-10-26 |
| 1346605425 | Kim I Evenson | Technician | 27911 Lake Diann Rd, Zimmerman, MN 55398-4268 | 2015-12-16 |
| 1073796322 | Life Senior Care Inc. | Home Health | 28347 112th St Nw, Zimmerman, MN 55398-4307 | 2007-12-10 |
| 1962525626 | Margery Ann Vetsch-peterson | Registered Nurse | 28347 112th St, Zimmerman, MN 55398-4307 | 2007-04-09 |
| 1346425543 | Open Harbors Inc. | Respite Care | 28347 112th St Nw, Zimmerman, MN 55398-4307 | 2008-01-07 |
| 1619367018 | Christy Jeanette White | Specialist/Technologist | 26479 Fremont Dr, Zimmerman, MN 55398-4566 | 2015-01-23 |
| 1306165618 | P&p Investors, Inc. | Psychologist | 25660 3rd St W, Suite 304, Zimmerman, MN 55398-4584 | 2010-05-26 |
| 1386709541 | Brian L Hoffmann | Chiropractor | 26250 2nd St W Ste 100, Zimmerman, MN 55398-4603 | 2006-12-27 |
| 1093125973 | Tyler Paul Roehl | Chiropractor | 15225 295th Ave Nw, Zimmerman, MN 55398-4657 | 2014-05-01 |
| Find all providers in zip 55398 | ||||
| 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 |
|---|---|---|---|---|
| 1619578648 | Kanika Lanese Baker | Prosthetic/Orthotic Supplier | 7240 Brooklyn Blvd Ste 150, Brooklyn Park, MN 55429-1274 | 2020-11-05 |
| 1932758067 | David Allen Young | Prosthetic/Orthotic Supplier | 1163 Wayzata Blvd E, Wayzata, MN 55391-1935 | 2019-09-11 |
| 1073080230 | Rebound Orthotics & Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 2805 Campus Dr Ste 101, Plymouth, MN 55441-2676 | 2018-10-25 |
| 1760998165 | Abilitech Medical, Inc. | Prosthetic/Orthotic Supplier | 628 Pine St, Saint Paul, MN 55130-4421 | 2017-12-20 |
| 1003351990 | Arise Orthotics & Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 8338 Highway 65 Ne, Suite E, Spring Lake Park, MN 55432-1364 | 2016-12-30 |
| 1073065298 | Language of Hair | Prosthetic/Orthotic Supplier | 1615 London Rd, Duluth, MN 55812-1620 | 2016-11-04 |
| 1275900664 | Nordstrom Inc & Subsidiaries | Prosthetic/Orthotic Supplier | 12401 Wayzata Blvd, Minnetonka, MN 55305-1974 | 2015-09-01 |
| 1427300706 | Rebound Orthotics & Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 1073 Highway 15 S, Plaza 15, Hutchinson, MN 55350-3153 | 2012-10-10 |
| 1033461322 | Rebound Orthotics & Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 300 Catlin St Ste 104, Buffalo, MN 55313-2035 | 2012-10-10 |
| 1487913554 | Otto Bock Healthcare Lp | Prosthetic/Orthotic Supplier | 14800 28th Ave N, Suite 110-d, Minneapolis, MN 55447-4873 | 2012-05-10 |
| 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.