NORTHERN BRACE COMPANY INC (NPI# 1790743821) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790743821 |
| Entity Type | Organization |
| Organization Name | NORTHERN BRACE COMPANY INC |
| Other Organization Name | NORTHERN BRACE NORTHERN PROSTHETICS |
| Practice Address |
53880 Carmichael Dr Ste. 220 South Bend IN 46635-1567 |
| Mailing Address |
610 N Michigan St Ste. 104 South Bend IN 46601-1077 |
| Practice Telephone | 5742775548 |
| Mailing Telephone | 5742775548 |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2012-12-07 |
| Authorized Official Name | KELLY L WEST (VICE PRESIDENT) |
| Authorized Official Telephone | 5742775548 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100153030B | 05 |
| Other Name | Type Code |
|---|---|
| Northern Brace Northern Prosthetics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881884971 | Northern Brace Company Inc | Durable Medical Equipment & Medical Supplies | 60160 Bodnar Blvd Ste. 200, Mishawaka, IN 46544 | 2007-07-26 |
| 1184682130 | Northern Brace Company Inc | Durable Medical Equipment & Medical Supplies | 610 N Michigan St, Suite 104, South Bend, IN 46601-1077 | 2006-05-01 |
| Street Address |
53880 CARMICHAEL DR STE. 220 |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46635-1567 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699764308 | Gary L. Armock | Physician Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2005-10-14 |
| 1972113496 | Jennifer Miller | Physical Therapy Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2020-08-10 |
| 1558971101 | Michelle Eichstedt | Physical Therapy Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2020-08-07 |
| 1316557390 | Kimberly Kinney | Physical Therapy Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2020-08-05 |
| 1023628005 | Melanie Daggy | Physical Therapy Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2020-08-05 |
| 1922618040 | Amy Tarwacki | Physical Therapy Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2020-08-04 |
| 1730720301 | Mackenzie S Warrick | Physician Assistant | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2019-10-03 |
| 1952950883 | Kyle Thomas Matheson | Physical Therapist | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2019-09-04 |
| 1851949440 | Karen Elizabeth Schneider-wensell | Physical Therapist | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2019-08-28 |
| 1174171763 | Elizabeth Anne Sullivan | Occupational Therapist | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2019-08-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295078228 | Michael Pfeiffer | Otolaryngology | 6301 University Commons Ste 360, South Bend, IN 46635 | 2013-03-27 |
| 1679833438 | Whitney Moore | Physical Therapy Assistant | 2012 Ironwood Circle, Suite 230, Circle Centre Building, South Bend, IN 46635 | 2012-05-25 |
| 1992917637 | Elly May Wynia | Social Worker | 53700 Generations Drive, Suite 200, South Bend, IN 46635 | 2007-05-04 |
| 1891917282 | Lifetime Dental Careof Indiana, PC | Dentist | 1605 North Ironwood, South Bend, IN 46635 | 2007-05-03 |
| 1750502878 | Tyrone Arteese Armstead | Pharmacist | 3355 Douglas Rd, South Bend, IN 46635 | 2007-05-02 |
| 1013033794 | Bradley Richard Swanson | Dentist | 54505 26th Street, Unit E, South Bend, IN 46635 | 2007-03-22 |
| 1225185739 | Michael J. O'connell D.o. Inc | Family Medicine | 17960 Cleveland Road, South Bend, IN 46635 | 2007-01-05 |
| 1346300365 | Chad Fulton Harrington | Dentist | 3340 Douglas Rd., South Bend, IN 46635 | 2006-12-11 |
| 1346313236 | Dr Shawn R Long Dds PC | Dentist | 16329 State Rd 23, South Bend, IN 46635 | 2006-11-16 |
| 1134206576 | Kearn David Hinchman | Psychiatry & Neurology | 53779 Generations Drive, Suite 1, South Bend, IN 46635 | 2006-11-01 |
| Find all providers in zip 46635 | ||||
| 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 |
|---|---|---|---|---|
| 1780681288 | American Limb & Orthopedic Co | Prosthetic/Orthotic Supplier | 2930 Mckinley Ave, South Bend, IN 46615-2739 | 2005-06-30 |
| 1629580758 | Ascendant Orthopedic Alliance, LLC | Prosthetic/Orthotic Supplier | 53880 Carmichael Dr, South Bend, IN 46635-1567 | 2017-10-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639781081 | Kenney Orthopedics Indianapolis, LLC | Prosthetic/Orthotic Supplier | 1801 N Senate Blvd Ste 420, Indianapolis, IN 46202-1228 | 2020-08-18 |
| 1982220109 | Bionic Prosthetics and Orthotics Group LLC | Prosthetic/Orthotic Supplier | 3647 Clifty Dr, Madison, IN 47250-1649 | 2020-06-23 |
| 1154941557 | Radiance Renewed | Prosthetic/Orthotic Supplier | 9445 Indianapolis Blvd Ste 1042, Highland, IN 46322-2648 | 2020-04-26 |
| 1295397735 | Orthopedic and Sports Medicine Center of Northern Indiana, Inc | Prosthetic/Orthotic Supplier | 200 E Jackson Blvd Ste 130, Elkhart, IN 46516-3513 | 2019-07-05 |
| 1710465166 | Cranial Technologies Inc | Prosthetic/Orthotic Supplier | 10603 N Meridian St Ste 120, Indianapolis, IN 46290-1055 | 2018-07-29 |
| 1285135913 | Excel Orthotics and Prosthetics LLC | Prosthetic/Orthotic Supplier | 3200 Sycamore Ct Ste 2b, Columbus, IN 47203-1552 | 2018-02-27 |
| 1003326174 | Bionic Prosthetics and Orthotics Group LLC | Prosthetic/Orthotic Supplier | 3130a Windsor Ct, Elkhart, IN 46514-5556 | 2017-10-03 |
| 1285144352 | Bionic Prosthetics and Orthotics Group LLC | Prosthetic/Orthotic Supplier | 1101 Glendale Blvd Ste 105, Valparaiso, IN 46383-3769 | 2017-10-03 |
| 1669904579 | Jordan Poynter | Prosthetic/Orthotic Supplier | 3708 S Lafountain St, Kokomo, IN 46902-3805 | 2017-03-30 |
| 1184156101 | Shawn Dee Brown | Prosthetic/Orthotic Supplier | 2410 N Glendale Dr Ste C, Fort Wayne, IN 46804-8909 | 2017-03-29 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BEND |
| Zip Code | 46635 |
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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.