FUNCTIONAL DME (NPI# 1407347586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407347586 |
| Entity Type | Organization |
| Organization Name | FUNCTIONAL DME |
| Practice Address |
219 W. Eastbank St., Ste B Gonzales LA 70737 |
| Mailing Address |
Po Box 77355 Baton Rouge LA 70879-7355 |
| Practice Telephone | 2254129955 |
| Practice Fax Number | 2254129957 |
| Mailing Telephone | 2254129955 |
| Mailing Fax Number | 2254129957 |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2019-12-17 |
| Authorized Official Name | COLLEEN RYAN (OWNER) |
| Authorized Official Telephone | 2254129955 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2494589 | 05 |
| Street Address |
219 W. EASTBANK ST., STE B |
| City | GONZALES |
| State | LA |
| Zip Code | 70737 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461593 | Scott G Petrie Md Apmc | Non-Pharmacy Dispensing Site | 1014 West St Clare Boulevard, Ste 1020, Gonzales, LA 70737 | 2020-09-15 |
| 1407461981 | Bryant Louis Bourgeois | Dentist | 13317 N Burnside, Gonzales, LA 70737 | 2020-09-11 |
| 1821612631 | Kene Anje Hamilton | Behavioral Analyst | 1028 East Worthy Street, Gonzales, LA 70737 | 2020-06-08 |
| 1801428636 | Mercedes Francis | Behavior Technician | 1023 E W Worthy Rd, Gonzales, LA 70737 | 2020-02-10 |
| 1235631789 | Transporting On Purpose | Non-emergency Medical Transport (VAN) | 42148 Conifer Drive, Gonzales, LA 70737 | 2018-03-01 |
| 1215453121 | Michelle Fuller Harris | Social Worker | 39094 N Angelle Ct, Gonzales, LA 70737 | 2017-08-22 |
| 1215452529 | Lani Litchfield | Specialist/Technologist | 13341 W. Mill Grove Dr, Gonzales, LA 70737 | 2017-08-08 |
| 1326569369 | Tyler Joshua Turner | Counselor | 1923 South Edwards, Gonzales, LA 70737 | 2017-06-29 |
| 1518408046 | Margaret Madere | Social Worker | 2827 S Ruby Street, Gonzales, LA 70737 | 2017-03-16 |
| 1225487937 | Veronica Smith | Registered Nurse | 1058 East Worthey Street Suite B, Gonzales, LA 70737 | 2016-06-03 |
| Find all providers in zip 70737 | ||||
| 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 |
|---|---|---|---|---|
| 1558970418 | B'obsessed Hair Collection | Prosthetic/Orthotic Supplier | 3009 Ray Weiland Dr, Baker, LA 70714-3251 | 2020-07-27 |
| 1093337305 | Sew Luxe Customs, LLC | Prosthetic/Orthotic Supplier | 8674 Quarters Lake Road, Building 11 Suit 1, Baton Rouge, LA 70809 | 2020-05-08 |
| 1831710060 | The Monte' Garcia Salon | Prosthetic/Orthotic Supplier | 10732 S Mall Dr Apt 423, Baton Rouge, LA 70809-4814 | 2020-04-28 |
| 1033746961 | Orthotic & Prosthetic Solutions LLC | Prosthetic/Orthotic Supplier | 11616 Southfork Ave Ste 202, Baton Rouge, LA 70816-5241 | 2020-03-23 |
| 1154953321 | One Source Inc. | Prosthetic/Orthotic Supplier | 1346 Lindberg Dr Ste 8, Slidell, LA 70458-8081 | 2020-02-06 |
| 1255975421 | Orthotic & Prosthetic Specialists, Inc. | Prosthetic/Orthotic Supplier | 10241 Coursey Blvd Ste C, Baton Rouge, LA 70816-0409 | 2019-10-31 |
| 1356908180 | Louisiana Prosthetics, LLC | Prosthetic/Orthotic Supplier | 4451 Bluebonnet Blvd Ste C, Baton Rouge, LA 70809-9647 | 2019-05-28 |
| 1295298321 | Swamp Elite Retreat Inc | Prosthetic/Orthotic Supplier | 46424 Rufus Bankston Rd, Hammond, LA 70401-6108 | 2019-04-06 |
| 1780142836 | Jaubert Prosthetics, LLC | Prosthetic/Orthotic Supplier | 1625 Ryan St Ste C, Lake Charles, LA 70601-5965 | 2019-03-07 |
| 1225501752 | Adaptive Prosthetics and Orthotics LLC | Prosthetic/Orthotic Supplier | 1208 Louise St, Thibodaux, LA 70301-4257 | 2019-01-08 |
| 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.