PEDS PLUS ORTHOTICS, LLC (NPI# 1447632690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447632690 |
| Entity Type | Organization |
| Organization Name | PEDS PLUS ORTHOTICS, LLC |
| Practice Address |
3851 Harrison Rd Benton AR 72019-9632 |
| Practice Telephone | 5016070144 |
| Practice Fax Number | 5017941021 |
| Mailing Telephone | 5016070144 |
| Mailing Fax Number | 5017941021 |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2015-06-24 |
| Authorized Official Name | BRYAN KEITH FLYNN (OWNER) |
| Authorized Official Telephone | 5016070144 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
Suppliers |
| Street Address |
3851 HARRISON RD |
| City | BENTON |
| State | AR |
| Zip Code | 72019-9632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962884114 | Bryan Keith Flynn | Orthotist | 3851 Harrison Rd, Benton, AR 72019-9632 | 2015-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841898293 | Arkansas Heart Hospital LLC | General Acute Care Hospital | 1901 Encore Way, Bryant, AR 72019 | 2020-10-16 |
| 1306485545 | Ryan Adams | Pharmacist | 20820 I-30 North, Benton, AR 72019 | 2020-01-06 |
| 1649819962 | Josh Landrum | Pharmacist | 20820 I 30 N, Benton, AR 72019 | 2020-01-03 |
| 1710525720 | Melanie Mabry | Nurse Practitioner | 11510 State Highway 298, Benton, AR 72019 | 2019-12-20 |
| 1578086864 | Ronald Winkler | Occupational Therapy Assistant | 2907 Hurricane Lake Rd, Bryant, AR 72019 | 2017-07-19 |
| 1801243357 | Richard Andrew Dwiggins | Social Worker | 1718 Old Hot Springs Highway, Benton, AR 72019 | 2016-05-14 |
| 1184008377 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 2080 I-30 North, Benton, AR 72019 | 2015-07-17 |
| 1689910051 | Rachel Cloud | Physical Therapist | 2010 Activeway, Benton, AR 72019 | 2012-12-12 |
| 1538444583 | Stacy Ann Harris | Specialist | 403 Demuth Lane, Benton, AR 72019 | 2011-10-20 |
| 1144528423 | Robert Mark Robinson | Licensed Practical Nurse | 5 Hickory Ridge Drive, Benton, AR 72019 | 2011-03-10 |
| Find all providers in zip 72019 | ||||
| Taxonomy Code | 332BC3200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Customized Equipment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891979647 | Jrj Supply LLC | Durable Medical Equipment & Medical Supplies | 132 Brown Rd, Benton, LA 71006-4715 | 2007-12-27 |
| 1932396207 | Mid-state Investments LLC | Durable Medical Equipment & Medical Supplies | 837 Us Highway 68 W, Benton, KY 42025-7418 | 2007-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871143941 | Amber Williams | Durable Medical Equipment & Medical Supplies | 9101 Auxor Rd Apt C24, Little Rock, AR 72209-6884 | 2019-09-19 |
| 1073058012 | A & A Home Health Equipment Inc. | Durable Medical Equipment & Medical Supplies | 17 Collins Industrial Place, Suite A, North Little Rock, AR 72113-7537 | 2016-12-29 |
| 1457724742 | Jacent Lamont Winston | Durable Medical Equipment & Medical Supplies | 13718 Trethorne Cir, North Little Rock, AR 72117-5052 | 2015-11-09 |
| 1447656095 | United Seating and Mobility LLC | Durable Medical Equipment & Medical Supplies | 5322 Bleaux Avenue, Suite D, Springdale, AR 72762-0729 | 2014-11-10 |
| 1003215096 | Asm, LLC | Durable Medical Equipment & Medical Supplies | 9871 Brockington Rd Ste 6, Sherwood, AR 72120-3592 | 2014-08-15 |
| 1053663062 | Contourmed | Durable Medical Equipment & Medical Supplies | 2217 Cottondale Ln, Little Rock, AR 72202-2018 | 2012-10-15 |
| 1275807315 | Invotek, Inc. | Durable Medical Equipment & Medical Supplies | 1026 Riverview Dr, Alma, AR 72921-7780 | 2012-03-07 |
| 1487949871 | Theracare | Durable Medical Equipment & Medical Supplies | 10707 Saint Michael Ct, Fort Smith, AR 72908-0993 | 2011-06-14 |
| 1629370317 | United Seating and Mobility LLC | Durable Medical Equipment & Medical Supplies | 1523 South Bowman Road, Suite A, Little Rock, AR 72211-4226 | 2010-12-01 |
| 1306071337 | Steppin Out Shoes & Accessories | Durable Medical Equipment & Medical Supplies | 1985 Kroger Dr, Suite A3, West Memphis, AR 72301-1771 | 2009-05-19 |
| 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.