JSC PEDORTHICS INC. (NPI# 1407904840) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407904840 |
| Entity Type | Organization |
| Organization Name | JSC PEDORTHICS INC. |
| Practice Address |
100 S State St Ste D Bunnell FL 32110-6115 |
| Practice Telephone | 3864370272 |
| Practice Fax Number | 3864370272 |
| Mailing Telephone | 3864370272 |
| Mailing Fax Number | 3864370272 |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | SCOTT D REEDY (PRESIDENT) |
| Authorized Official Telephone | 3864370272 |
| Authorized Official Credential | C.PED. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | PED 53 | FL | Suppliers |
| Street Address |
100 S STATE ST STE D |
| City | BUNNELL |
| State | FL |
| Zip Code | 32110-6115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669017349 | Ashley Jessica Harris | Nurse Practitioner | 2795 County Road 13, Bunnell, FL 32110 | 2019-11-17 |
| 1407321698 | Medical Risk Solutions | Family Medicine | 1769 E. Moody Blvd, Bunnell, FL 32110 | 2018-10-04 |
| 1518225408 | Christopher Manly Deck | Occupational Therapy Assistant | 5795 Chestnut Ave, Bunnell, FL 32110 | 2012-04-27 |
| 1588947337 | Flagler Mental Health Center, Pa | Community/Behavioral Health | 2729 E. Moody Blvd Ste 105, Bunnell, FL 32110 | 2011-09-27 |
| 1922273606 | Nancy Hutt Culver | Technician | 2384 County Rd 305, Bunnell, FL 32110 | 2008-04-24 |
| 1487772984 | Jennifer Lois Fraser | Dentist | 35 Caroline Street, Bunnell, FL 32110 | 2007-03-26 |
| 1750463154 | Jennifer L Thornton | Chiropractor | 4721 East Moody Blvd, Suite101, Bunnell, FL 32110 | 2006-10-19 |
| 1720175649 | Bunnell Medical Center Inc | Family Medicine | 700 E. Moody Blvd, Bunnell, FL 32110 | 2006-10-10 |
| 1245326990 | Patrick Gerald Reed | Chiropractor | 4601 East Highway 100, Suite G4, Bunnell, FL 32110 | 2006-10-04 |
| 1013000652 | Flagler Diagnostic & Sleeping Disorder, Inc, Inc | Clinic/Center | 4721 E. Moody Blvd Suite 104, Bunnell, FL 32110 | 2006-10-02 |
| Find all providers in zip 32110 | ||||
| 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 |
|---|---|---|---|---|
| 1073120192 | Solaris Ortho, LLC | Prosthetic/Orthotic Supplier | 1112 W Shell Point Rd Ste 304, Ruskin, FL 33570-3400 | 2020-09-24 |
| 1467068635 | Laquavian Eliacin | Prosthetic/Orthotic Supplier | 1738 Se Port St Lucie Blvd, Port St Lucie, FL 34952-5467 | 2020-09-22 |
| 1831705805 | Fourroux Prosthetics, Inc | Prosthetic/Orthotic Supplier | 5453 N 59th St, Tampa, FL 33610-2011 | 2020-09-16 |
| 1790397875 | Gessy Rigaud | Prosthetic/Orthotic Supplier | 5100 Sw 41st St Apt 115, Hollywood, FL 33023-6988 | 2020-08-19 |
| 1609486737 | Beauty Vault Lux LLC. | Prosthetic/Orthotic Supplier | 5100 Sw 41st St, Hollywood, FL 33023-6948 | 2020-08-04 |
| 1003424680 | Spartan Capital Investments | Prosthetic/Orthotic Supplier | 1621 E Edgewood Dr Ste B, Lakeland, FL 33803-3365 | 2020-07-20 |
| 1518583012 | Ts&a Medical Supply LLC | Prosthetic/Orthotic Supplier | 13555 Automobile Blvd Ste 650, Clearwater, FL 33762-3854 | 2020-06-19 |
| 1962027128 | Qbc Durable Medical Equipment | Prosthetic/Orthotic Supplier | 931 Village Blvd # 256, West Palm Beach, FL 33409-1803 | 2020-06-13 |
| 1083239891 | K.n. Medical Wigs Inc | Prosthetic/Orthotic Supplier | 651 E Main St Ste I, Haines City, FL 33844-4240 | 2020-06-08 |
| 1730703851 | Mahnke's Orthotics & Prosthetics of Deerfield Inc | Prosthetic/Orthotic Supplier | 4208 N 31st Ave Ste 2, Hollywood, FL 33021-2002 | 2020-06-04 |
| 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.