CANTON ORTHOTIC LABORATORY INC (NPI# 1720080005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720080005 |
| Entity Type | Organization |
| Organization Name | CANTON ORTHOTIC LABORATORY INC |
| Practice Address |
811 12th St Nw Canton OH 44703-1927 |
| Practice Telephone | 3304542081 |
| Practice Fax Number | 3304549568 |
| Mailing Telephone | 3304542081 |
| Mailing Fax Number | 3304549568 |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. STEPHEN THOMAS SIMKO (PRESIDENT/LICENSED ORTHOTIST) |
| Authorized Official Telephone | 3304542081 |
| Authorized Official Credential | LO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers | ||
| Y | 335E00000X | Prosthetic/Orthotic Supplier | OH | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0291143 | 05 | |
| OH | ANTHEM PROVIDER NUMBER | 000000155415 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073576617 | Canton Orthotic Laboratory Inc | Durable Medical Equipment & Medical Supplies | 2400 Wales Ave Nw, Suite H, Massillon, OH 44646-0804 | 2006-04-06 |
| Street Address |
811 12TH ST NW |
| City | CANTON |
| State | OH |
| Zip Code | 44703-1927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245870591 | Adriane Everett | Counselor | 906 12 St Nw, Canton, OH 44703 | 2020-01-14 |
| 1154792497 | Jasmine Brown | Home Health Aide | 926 Mcgregor Ave N W, Canton, OH 44703 | 2015-10-13 |
| 1538563366 | Lauren Miller | Psychologist | 1503 Woodland Ave Nw, Canton, OH 44703 | 2014-10-22 |
| 1891863478 | Judson Graham Sprandel II | Chiropractor | 1412 Cleveland Ave Nw, Canton, OH 44703 | 2006-12-01 |
| 1376616276 | Charles S Yarnevich | Podiatrist | 1548 Fulton Rd Nw, Canton, OH 44703 | 2006-11-16 |
| 1538760624 | Medtime Pharmacy LLC | Pharmacy | 400 12th St Nw, Address Line 2, Canton, OH 44703 | 2020-11-04 |
| 1598250243 | Charles W Schott | Case Manager/Care Coordinator | 832 Mckinley Ave Nw, Canton, OH 44703 | 2018-06-26 |
| 1366831471 | Rebecca L Reigle | Registered Nurse | 832 Mckinley Ave Nw, Canton, OH 44703 | 2015-01-13 |
| 1629247960 | Sprandel Chiropractic Clinic Inc | Chiropractor | 1412 Cleveland Ave Nw, Canton, OH 44703 | 2008-02-20 |
| 1063019024 | Pamela Kay Pirolozzi | Home Health Aide | 1520 16th St Nw, Canton, OH 44703-1040 | 2020-10-02 |
| Find all providers in zip 44703 | ||||
| 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 |
|---|---|---|---|---|
| 1689296022 | Glitterati Luxury Virgin Hair Bar | Prosthetic/Orthotic Supplier | 4786 Dressler Rd Nw # 128, Canton, OH 44718-2555 | 2020-05-07 |
| 1225482763 | Howard Orthotics and Prosthetics, LLC | Prosthetic/Orthotic Supplier | 6128 Us Highway11, Canton, NY 13617 | 2016-04-21 |
| 1659731388 | Northern Orthopedic Laboratory Inc. | Prosthetic/Orthotic Supplier | 3 Remington Ave, Canton, NY 13617-3602 | 2016-02-23 |
| 1811127004 | Lucky Shoes Inc | Prosthetic/Orthotic Supplier | 4840 Everhard Rd Nw, Canton, OH 44718-2413 | 2009-07-22 |
| 1679676241 | Yanke Bionics Inc | Prosthetic/Orthotic Supplier | 4694 W Tuscarawas St, Canton, OH 44708 | 2006-09-07 |
| 1285639989 | Marquis Healthcare, Inc. | Prosthetic/Orthotic Supplier | 4051 Whipple Ave Nw, Ste. A, Canton, OH 44718-2977 | 2005-06-17 |
| 1982052692 | Premier Hope Orthotic & Prosthetic Enterprises of Mississippi, LLC | Prosthetic/Orthotic Supplier | 152 Watford Park Way Dr, Suite 147, Canton, MS 39046-7900 | 2016-06-03 |
| 1225231103 | Mercy Medical Center, Inc. | Prosthetic/Orthotic Supplier | 1320 Mercy Dr Nw, Canton, OH 44708-2614 | 2007-06-07 |
| 1548284029 | Perrotta Prosthetics and Orthotics LLC | Prosthetic/Orthotic Supplier | 141 Dowd Ave, Canton, CT 06019-2401 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487277323 | Diamond Laced Medical Wigs | Prosthetic/Orthotic Supplier | 7373 Brookcrest Dr, Cincinnati, OH 45237-3446 | 2020-05-27 |
| 1629601067 | Ann Marie Braydich | Prosthetic/Orthotic Supplier | 5527 Walnut Grove Cir, Struthers, OH 44471-3116 | 2020-02-13 |
| 1124661491 | John Keenan | Prosthetic/Orthotic Supplier | 11075 Westborough Rd, Parma Heights, OH 44130-3014 | 2019-10-19 |
| 1255985404 | Boston Brace International Inc. | Prosthetic/Orthotic Supplier | 17900 Jefferson Park Rd Ste 100, Middleburg Heights, OH 44130-3437 | 2019-07-26 |
| 1073077590 | Spicer Orthopedics, LLC | Prosthetic/Orthotic Supplier | 1830 Ridge Rd Nw, Bolivar, OH 44612-8512 | 2019-01-29 |
| 1851864953 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 500 E Main St Ste 250, Columbus, OH 43215-5369 | 2019-01-10 |
| 1104399138 | American Orthopedics Inc | Prosthetic/Orthotic Supplier | 1459 Marion Waldo Rd Ste 230, Marion, OH 43302-7421 | 2019-01-02 |
| 1851867212 | Ohrh, LLC | Prosthetic/Orthotic Supplier | 574 N State St Ste B, Westerville, OH 43082-6058 | 2018-10-23 |
| 1194291633 | Ohrh, LLC | Prosthetic/Orthotic Supplier | 1210 Gemini Pl Ste 320, Columbus, OH 43240-6109 | 2018-10-23 |
| 1619443066 | Ohrh, LLC | Prosthetic/Orthotic Supplier | 2185 Stringtown Rd Unit 11, Grove City, OH 43123-2989 | 2018-10-23 |
| 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.