RANDY WHITESIDE PROSTHETICS LLC (NPI# 1609386853) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609386853 |
| Entity Type | Organization |
| Organization Name | RANDY WHITESIDE PROSTHETICS LLC |
| Practice Address |
1190 E Missouri Ave Ste 190 Phoenix AZ 85014-2736 |
| Practice Telephone | 6025961040 |
| Practice Fax Number | 4802125944 |
| Mailing Telephone | 6025961040 |
| Mailing Fax Number | 4802125944 |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2017-10-02 |
| Authorized Official Name | MR. RANDALL WHITESIDE (MANAGER) |
| Authorized Official Telephone | 6025964010 |
| Authorized Official Credential | CP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224P00000X | Prosthetist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1190 E MISSOURI AVE STE 190 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85014-2736 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871017137 | Randall Scott Whiteside | Prosthetist | 1190 E Missouri Ave Ste 190, Phoenix, AZ 85014-2736 | 2017-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831796549 | Sherri Ann Rhodes | Registered Nurse | 5727 North 7th Street, Suite 308, Phoenix, AZ 85014 | 2020-10-06 |
| 1235746249 | Kaitlyn Landess | Occupational Therapist | 1190 W. Missouri Ave, Suite 100, Phoenix, AZ 85014 | 2020-09-24 |
| 1467088062 | Generational Bridges Neuropsychological Services Pllc | Clinical Neuropsychologist | 1515 E Missouri Dr, Phoenix, AZ 85014 | 2020-03-16 |
| 1861022881 | Daza Astrid Hernandez | Speech-Language Pathologist | 5314 N 7th Street, Phoeniz, AZ 85014 | 2020-01-17 |
| 1396213542 | Arizona Youth & Family Services Inc. | Community/Behavioral Health | 3707 N. 7th Street, Ste. 200, Phoenix, AZ 85014 | 2018-11-06 |
| 1366815508 | Dehp LLC | Case Management | 3707 N. 7th St., Ste # 310, Phoenix, AZ 85014 | 2015-11-10 |
| 1659751972 | Carla Parola | Counselor | 1300 E Missouri Ave Ste A-120, Phoenix, AZ 85014 | 2015-06-02 |
| 1659763597 | Dale Carroll Davis | Dentist | 3132 N. 7th St, Phoenix, AZ 85014 | 2015-03-02 |
| 1407247091 | Cynthia Ruzich | Psychologist | 1450 E. Indian School Rd. #101, Phoenix, AZ 85014 | 2015-02-18 |
| 1144618315 | Emily M Bentz | Specialist/Technologist | 3514 N. 7th St, Phoenix, AZ 85014 | 2014-12-22 |
| Find all providers in zip 85014 | ||||
| Taxonomy Code | 224P00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Prosthetist |
| A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| 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 |
|---|---|---|---|---|
| 1063020972 | Kaitlin Quan | Prosthetist | 1131 E Highland Ave, Phoenix, AZ 85014-3639 | 2020-07-16 |
| 1528620101 | Lisa Marie Bowers | Prosthetist | 3330 E Wahalla Ln, Phoenix, AZ 85050-7904 | 2019-07-03 |
| 1871017137 | Randall Scott Whiteside | Prosthetist | 1190 E Missouri Ave Ste 190, Phoenix, AZ 85014-2736 | 2017-07-28 |
| 1912092610 | Stephen Mitchell Mcnamee | Prosthetist | 4501 N 32nd St, Phoenix, AZ 85018-3339 | 2006-10-04 |
| 1841806262 | Anthony Berland | Prosthetist | 4445 N 7th St, Phoenix, AZ 85014-4139 | 2020-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770938946 | Lorin Christopher Merkley | Prosthetist | 4135 S Power Rd Ste 127, Mesa, AZ 85212-3627 | 2016-04-25 |
| 1427317429 | Seth O'brien | Prosthetist | 2058 S Dobson Rd Ste 17, Mesa, AZ 85202 | 2012-05-10 |
| 1316268485 | Gregory Talen | Prosthetist | 3173 N Windsong Dr, Prescott Valley, AZ 86314-2240 | 2010-06-11 |
| 1437302544 | Prosthetic Center LLC | Prosthetist | 8440 E. Mcdonald Drive, Prosthetic Center Suite B, Scottsdale, AZ 85250-8300 | 2008-11-03 |
| 1861948242 | Nextremity Prosthetic Design | Prosthetist | 4135 S Power Rd Ste 127, Mesa, AZ 85212-3627 | 2016-08-26 |
| 1649424185 | Alan S Cota | Prosthetist | 3601 S 6th Avenue, Tucson Vamc, 05-121, Tucson, AZ 58723-0001 | 2008-11-11 |
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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.