HEARTLAND ORTHOTIC & PROSTHETIC LAB (NPI# 1790900678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790900678 |
| Entity Type | Organization |
| Organization Name | HEARTLAND ORTHOTIC & PROSTHETIC LAB |
| Practice Address |
322 W Macarthur St Shawnee OK 74804-1908 |
| Practice Telephone | 4052141924 |
| Practice Fax Number | 4052141110 |
| Mailing Telephone | 4052141924 |
| Mailing Fax Number | 4052141110 |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | LANCE ELIOT FAULKNER (OWNER) |
| Authorized Official Telephone | 4052141924 |
| Authorized Official Credential | BOC CP PLP02 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | C15550 | OK | Suppliers |
| Street Address |
322 W MACARTHUR ST |
| City | SHAWNEE |
| State | OK |
| Zip Code | 74804-1908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164063699 | Isaac Benjamin Gray | Student in an Organized Health Care Education/Training Program | 4010 Blaine Road, Shawnee, OK 74804 | 2019-10-06 |
| 1750863775 | Dillon Gibson | Specialist/Technologist | Oklahoma Baptist University, 500 W. University, Shawnee, OK 74804 | 2018-09-06 |
| 1912368242 | Peggy Baker | Occupational Therapist | 7602 N. Kickapoo, Shawnee, OK 74804 | 2016-03-15 |
| 1861731093 | Shariff Mohammed El-assi | Behavioral Analyst | 45 Crown Point, Shawnee, OK 74804 | 2013-02-07 |
| 1902103112 | Action Physical Therapy & Rehabilitation, Pllc | Physical Therapist | 2506 N Harrison, Shawnee, OK 74804 | 2011-02-24 |
| 1639493315 | Oklahoma Em - 1 Medical Services,p.c. | Emergency Medicine | 1102 W.macarthur, Shawnee, OK 74804 | 2010-03-24 |
| 1790989473 | Eastern Oklahoma Radiation Associates, LLC | Radiology | 3700 N Kickapoo Ave Ste 108, Shawnee, OK 74804 | 2007-06-14 |
| 1821210444 | Mickey Sehorn D.d.s., P.C. | Dentist | 1601 Airport Drive, Shawnee, OK 74804 | 2007-05-03 |
| 1760525711 | Leanna Rae Olsen | Registered Nurse | 1500 N. Kickapoo, Suite #4, Shawnee, OK 74804 | 2007-02-15 |
| 1467517920 | Mahmoud Abdel-fattah Khalifa | Pathology | Unity Health Center, 1102 West Macarthur, Shawnee, OK 74804 | 2006-12-26 |
| Find all providers in zip 74804 | ||||
| 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 |
|---|---|---|---|---|
| 1265630867 | Turntine Ocular Prosthetics, Inc | Prosthetic/Orthotic Supplier | 6342 Long St, Suite H, Shawnee, KS 66216-2560 | 2007-07-05 |
| 1174555429 | Turntine Ocular Prosthetics, Inc | Prosthetic/Orthotic Supplier | 6342 Long St, Suite H, Shawnee, KS 66216-2560 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619515541 | Lamoor Beauty Supply | Prosthetic/Orthotic Supplier | 2214 N Martin Luther King Ave, Oklahoma City, OK 73111-2404 | 2019-12-10 |
| 1790246361 | Capitol Orthopedic Inc | Prosthetic/Orthotic Supplier | 5480 Main St, Del City, OK 73115-5516 | 2019-03-27 |
| 1841776705 | Progressive Orthotic & Prosthetic Services, Inc | Prosthetic/Orthotic Supplier | 10 E 6th St., Grove, OK 74344 | 2018-07-13 |
| 1598258378 | Otto Bock Orthopedic Services LLC | Prosthetic/Orthotic Supplier | 5601 Nw 72nd Street, Suite 257, Oklahoma City, OK 73132-5920 | 2018-06-07 |
| 1508363482 | Progressive Orthotic & Prosthetic Services, Inc | Prosthetic/Orthotic Supplier | 2121 S Columbia Ave Ste Ll8, Tulsa, OK 74114-3512 | 2018-04-09 |
| 1093237711 | Elevate Orthotics and Prosthetics LLC | Prosthetic/Orthotic Supplier | 3317 E Memorial Rd Ste 103, Edmond, OK 73013-7095 | 2017-07-14 |
| 1710413489 | Raymon Turpin | Prosthetic/Orthotic Supplier | 6565 S Yale Ave Ste 901, Tulsa, OK 74136-8310 | 2017-05-02 |
| 1265970040 | Fenner, Inc | Prosthetic/Orthotic Supplier | 2019 W Broadway St, Muskogee, OK 74401-2759 | 2017-02-01 |
| 1336510874 | Tatas for Now | Prosthetic/Orthotic Supplier | 2319 W Gore Blvd, Lawton, OK 73505-6301 | 2015-10-09 |
| 1639577885 | La Fuente Prosthetics | Prosthetic/Orthotic Supplier | 229 N.w. 9th Street, Oklahoma City, OK 73102 | 2014-12-19 |
| 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.