ORTHOTIC & PROSTHETIC CENTERS, INC. (NPI# 1811305048) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811305048 |
| Entity Type | Organization |
| Organization Name | ORTHOTIC & PROSTHETIC CENTERS, INC. |
| Other Organization Name | ORTHOTIC & PROSTHETIC CENTER OF JACKSONVILLE |
| Practice Address |
1721 Atlantic Blvd Ste 100 Jacksonville FL 32207-3475 |
| Mailing Address |
3611 5th Ave N St Petersburg FL 33713-7503 |
| Practice Telephone | 9045497755 |
| Practice Fax Number | 8557772595 |
| Mailing Telephone | 7273273332 |
| Mailing Fax Number | 7273277304 |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2019-01-16 |
| Authorized Official Name | MOLLY K FORTE (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 7273273332 |
| Is Organization Subpart | Y |
| Parent Organization Name | ORTHOTIC & PROSTHETIC CENTERS, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | FL | Suppliers | |
| N | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
FL | Suppliers | |
| Y | 335E00000X | Prosthetic/Orthotic Supplier | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 012837700 | 05 |
| Other Name | Type Code |
|---|---|
| ORTHOTIC & PROSTHETIC CENTER OF JACKSONVILLE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629627484 | Orthotic & Prosthetic Centers, Inc. | Durable Medical Equipment & Medical Supplies | 9808 Millwood Cir Ste A, Daphne, AL 36527-5455 | 2019-09-05 |
| 1376039032 | Orthotic & Prosthetic Centers, Inc. | Durable Medical Equipment & Medical Supplies | 2316 Lakeland Hills Blvd, Lakeland, FL 33805-2910 | 2018-07-06 |
| 1508352204 | Orthotic & Prosthetic Centers, Inc. | Durable Medical Equipment & Medical Supplies | 7070 Mariner Blvd, Spring Hill, FL 34609-1046 | 2018-07-05 |
| 1427404508 | Orthotic & Prosthetic Centers, Inc. | Durable Medical Equipment & Medical Supplies | 3936 N Davis Hwy Ste C, Pensacola, FL 32503-2746 | 2016-05-09 |
| 1821453366 | Orthotic & Prosthetic Centers, Inc. | Durable Medical Equipment & Medical Supplies | 851 Dunlawton Ave Ste 101, Port Orange, FL 32127-4234 | 2015-12-29 |
| 1497120935 | Orthotic & Prosthetic Centers, Inc. | Durable Medical Equipment & Medical Supplies | 1425 Viscaya Pkwy Ste 102, Cape Coral, FL 33990-3294 | 2015-12-09 |
| 1275901191 | Orthotic & Prosthetic Centers, Inc. | Durable Medical Equipment & Medical Supplies | 47 W New Haven Ave Ste 102, Melbourne, FL 32901-4477 | 2015-09-09 |
| 1801264254 | Orthotic & Prosthetic Centers, Inc. | Durable Medical Equipment & Medical Supplies | 3403 Nw 55th St, Fort Lauderdale, FL 33309-6308 | 2015-09-02 |
| 1215311477 | Orthotic & Prosthetic Centers, Inc. | Durable Medical Equipment & Medical Supplies | 400 Avenue K Se Ste 7, Winter Haven, FL 33880-4123 | 2015-07-16 |
| 1841607066 | Orthotic & Prosthetic Centers, Inc. | Durable Medical Equipment & Medical Supplies | 5053 S Congress Ave Ste 202, Lake Worth, FL 33461-4706 | 2014-07-21 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ORTHOTIC & PROSTHETIC CENTERS, INC. | 10420 Park Rd Ste 100a, Charlotte, NC 28210-8501 |
| Street Address |
1721 ATLANTIC BLVD STE 100 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32207-3475 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033768981 | North Florida Pediatrics, Pa | Pediatrics | 4501 Atlantic Boulevard, Jacksonville, FL 32207 | 2019-09-04 |
| 1578117024 | Pragna Mukesh Dholakia | Nurse Practitioner | 2624 Atlantic Blvd., Jacksonville, FL 32207 | 2019-08-01 |
| 1821653601 | The Adoption Authority, Inc. | Case Management | 4940 Emerson Street, Suite 103, Jacksonville, FL 32207 | 2019-05-07 |
| 1255896080 | Elizabeth Lynn Houghton | Social Worker | Sulzbacher Village, 904-720-2079, Jacksonville, FL 32207 | 2019-02-06 |
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1073008504 | Pavilion Infusion Therapy Inc | Durable Medical Equipment & Medical Supplies | 1301 Palm Avenue, Suite 220, Jacksonville, FL 32207 | 2018-06-27 |
| 1346733185 | Dueseason1 | Registered Nurse | 4058 Saint Augustine Rd, Jacksonville, FL 32207 | 2018-06-06 |
| 1164911913 | Eric Lang Poovey | Nurse Practitioner | Baptist Heart Specialists, 836 Prudential Drive Suite 1700, Jacksonville, FL 32207 | 2018-05-08 |
| 1902311046 | Spring Park Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3851 Emerson St Ste 13, Jacksonville, FL 32207 | 2017-12-12 |
| 1295247948 | Emed Urgent and Primary Care Pa | Clinic/Center | 2570 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
| Find all providers in zip 32207 | ||||
| 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 |
|---|---|---|---|---|
| 1295367837 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 1300 Riverplace Blvd Ste 100, Jacksonville, FL 32207-1815 | 2020-02-11 |
| 1952955627 | B Jazzy Salon Inc | Prosthetic/Orthotic Supplier | 5116 Gate Pkwy Apt 5111, Jacksonville, FL 32256-0265 | 2019-07-30 |
| 1043771777 | Jimetra West | Prosthetic/Orthotic Supplier | 1449 Morgana Rd, Jacksonville, FL 32211-4910 | 2019-03-26 |
| 1144769092 | Nupath Medical LLC | Prosthetic/Orthotic Supplier | 11244 Turnbridge Dr, Jacksonville, FL 32256-2342 | 2017-02-13 |
| 1700287018 | Janet Johnson | Prosthetic/Orthotic Supplier | 3132 Beach Blvd, Jacksonville, FL 32207-3710 | 2014-09-07 |
| 1043619166 | Nordstrom Inc & Subsidiaries | Prosthetic/Orthotic Supplier | 4835 Town Crossing Drive, Jacksonville, FL 32246-8577 | 2014-08-14 |
| 1053679365 | Jean T. Proulx | Prosthetic/Orthotic Supplier | 3132 Beach Boulevard, Jacksonville, FL 32207-3710 | 2012-04-25 |
| 1023309572 | Bremer Brace of Florida, Inc. | Prosthetic/Orthotic Supplier | 4131 University Blvd S Ste 16, Jacksonville, FL 32216-4346 | 2011-05-02 |
| 1720227465 | Kathleen Elizabeth Brockway | Prosthetic/Orthotic Supplier | 13740 Beach Blvd Ste 404, Jacksonville, FL 32224-6036 | 2009-02-19 |
| 1760637599 | Brandis Wig Salon | Prosthetic/Orthotic Supplier | 7275 103rd St, Jacksonville, FL 32210 | 2008-11-20 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32207 |
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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.