MD ORTHOTIC AND PROSTHETIC LABORATORIES, INC. (NPI# 1932153418) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932153418 |
| Entity Type | Organization |
| Organization Name | MD ORTHOTIC AND PROSTHETIC LABORATORIES, INC. |
| Practice Address |
9521 Indianapolis Blvd Suite B Highland IN 46322 |
| Mailing Address |
741 W Main St Peoria IL 61606-1953 |
| Practice Telephone | 2197368896 |
| Practice Fax Number | 8886353135 |
| Mailing Telephone | 8003345705 |
| Mailing Fax Number | 8886636322 |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2018-07-30 |
| Authorized Official Name | DONALD GOERTZEN (PRESIDENT) |
| Authorized Official Telephone | 3096762276 |
| Authorized Official Credential | CPO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200161960 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679625560 | Md Orthotic and Prosthetic Laboratories, Inc. | Prosthetic/Orthotic Supplier | 8400 Brookfield Ave, 1st Floor, Brookfield, IL 60513 | 2007-01-18 |
| Street Address |
9521 INDIANAPOLIS BLVD SUITE B |
| City | HIGHLAND |
| State | IN |
| Zip Code | 46322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386052975 | Caregiver Staffing, Inc. | Home Health | 9521 Indianapolis Blvd, Suite O, Highland, IN 46322-2639 | 2014-07-26 |
| 1851444251 | Debby Hermosura Rodriguez | Optometrist | 9521 Indianapolis Blvd, Highland, IN 46322-2639 | 2007-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013431733 | Marielva Banks | Physician Assistant | 10343 Indianapolis Blvd Ste 104, Highland, IN 46322 | 2017-08-03 |
| 1467806596 | Archangel Home Care Inc | Home Health | 2148 45th Ste 205, Highland, IN 46322 | 2016-04-14 |
| 1427457886 | Veronica Addison | Community/Behavioral Health | 219 Indianapolis Blvd, Ste B, Highland, IN 46322 | 2014-08-21 |
| 1750700423 | Persa Darnell | Nurse Practitioner | 3747 45th Ave., Highland, IN 46322 | 2014-04-10 |
| 1043648207 | Wahbi Adad | Specialist | 8732 Woodward Ave, Highland, IN 46322 | 2013-10-28 |
| 1619229317 | Cleotis White | Counselor | 2646 Highway Ave Ste 108, Highland, IN 46322 | 2012-10-05 |
| 1912278904 | Noble Home Health Care LLC | Home Health | 2449 45th St, Suite D, Highland, IN 46322 | 2012-01-23 |
| 1891926531 | Saket B Sinha | Internal Medicine | 9030 Cline Ave, Highland, IN 46322 | 2009-07-29 |
| 1194998963 | Affordable Hearing Aid Center | Hearing Instrument Specialist | 2148 45th St, Highland, IN 46322 | 2008-04-11 |
| 1497954390 | Highland Clinic of Northwest Indiana Inc | General Practice | 2834 Highway Ave Ste 1, Highland, IN 46322 | 2007-07-12 |
| Find all providers in zip 46322 | ||||
| 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 |
|---|---|---|---|---|
| 1154941557 | Radiance Renewed | Prosthetic/Orthotic Supplier | 9445 Indianapolis Blvd Ste 1042, Highland, IN 46322-2648 | 2020-04-26 |
| 1275847246 | Center for Orthotic & Prosthetic Excellence, LLC | Prosthetic/Orthotic Supplier | 2213 Main St Unit 1c-102, Highland, IN 46322-3514 | 2010-08-02 |
| 1063772259 | Alpine Foot and Ankle Corp | Prosthetic/Orthotic Supplier | 5455 W 11000 N Ste 203, Highland, UT 84003-8802 | 2012-05-21 |
| 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 |
| 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 |
| 1346771029 | Stride Prosthetics LLC | Prosthetic/Orthotic Supplier | 2498 Perry Crossing Way Ste 260, Plainfield, IN 46168-5520 | 2017-03-23 |
| 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.