CORDELIA KNOTT WELLNESS FOUNDATION (NPI# 1932196847) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932196847 |
| Entity Type | Organization |
| Organization Name | CORDELIA KNOTT WELLNESS FOUNDATION |
| Other Organization Name | SHOP ON MAIN |
| Practice Address |
230 S Main St Suite 100 Orange CA 92868-3851 |
| Practice Telephone | 7145415563 |
| Practice Fax Number | 7146193336 |
| Mailing Telephone | 7145415563 |
| Mailing Fax Number | 7146193336 |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2010-08-02 |
| Authorized Official Name | MS. SHIRLEY JOYCE MORETTI (PRESIDENT) |
| Authorized Official Telephone | 7145690318 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | C20007 | CA | Suppliers |
| Other Name | Type Code |
|---|---|
| Shop on Main | Doing Business As Name - Organization |
| Street Address |
230 S MAIN ST SUITE 100 |
| City | ORANGE |
| State | CA |
| Zip Code | 92868-3851 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033642434 | Krystle Cummins | Registered Nurse | 230 S Main St, Orange, CA 92868-3851 | 2017-04-04 |
| 1063818912 | Linda Joyce Buck | Nurse Practitioner | 230 S Main St, Suite 100, Orange, CA 92868-3851 | 2014-11-05 |
| 1366846776 | Nina Luong | Physician Assistant | 230 S Main St, Ste 210, Orange, CA 92868-3851 | 2014-10-14 |
| 1053753913 | Jennifer Swisher | Physician Assistant | 230 S Main St, Suite 100, Orange, CA 92868-3851 | 2013-07-20 |
| 1245503721 | Lisa Ann Donley-lanyi | Marriage & Family Therapist | 230 S Main St, Suite 100, Orange, CA 92868-3851 | 2012-02-15 |
| 1376791616 | Justin Eric West | Surgery | 230 S Main St, Suite 210, Orange, CA 92868-3851 | 2008-08-28 |
| 1659548691 | Jonathan Amer Zelken | Surgery | 230 S Main St, Ste 210, Orange, CA 92868-3851 | 2008-05-09 |
| 1538334289 | Won K Yu Md Mph Inc | Internal Medicine | 230 S Main St, Ste 215, Orange, CA 92868-3851 | 2008-04-24 |
| 1447435144 | Leah Marie Wilson | Nurse Practitioner | 230 S Main St, Suite 100, Orange, CA 92868-3851 | 2008-01-01 |
| 1417138538 | Holly Sata Md, Professional Corporation | Anesthesiology | 230 S Main St, Suite 210, Orange, CA 92868-3851 | 2007-11-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346859386 | Sadaf Abrishami | Pharmacist | 101 The City Dr S., Orange, CA 92868 | 2020-07-27 |
| 1245869825 | Helena Yijia Hong | Student in an Organized Health Care Education/Training Program | Uci Medical Center, 101 The City Drive, Orange, CA 92868 | 2020-04-06 |
| 1932736527 | Joshua Kristopher Livingston | Student in an Organized Health Care Education/Training Program | 101 The City Dr S, Rte. 128-01, Orange, CA 92868 | 2020-03-24 |
| 1831725894 | Michelle Brown | Student in an Organized Health Care Education/Training Program | 101 The City Dr S. Rte 128-01, Orange, CA 92868 | 2020-03-20 |
| 1093363491 | Kristin Lee | Pharmacist | 132 S. Anita Dr., Orange, CA 92868 | 2019-08-28 |
| 1740834217 | Matthew Brian Mecheal | Dentist | 725 W. La Veta Suite 260, Orange, CA 92868 | 2019-08-01 |
| 1245897990 | Brent Tyler Louie | Student in an Organized Health Care Education/Training Program | 101 The City Drive South Building 3, Route 88, Neuropsychiatric Center Uc Irvine Medical Center, Orange, CA 92868 | 2019-05-28 |
| 1093277972 | Danielle Amato | Student in an Organized Health Care Education/Training Program | Uc Irvine Health 101 The City Drive, City Tower, Ste 40, Orange, CA 92868 | 2019-04-01 |
| 1851852206 | Julia Ting Bu | Student in an Organized Health Care Education/Training Program | Uc Irvine Health, 101 The City Drive, City Tower, Ste 400, Orange, CA 92868 | 2019-03-28 |
| 1326507344 | Harrison Beene Lowder | Student in an Organized Health Care Education/Training Program | 505 S. Main St, Suite 525, Orange, CA 92868 | 2019-03-19 |
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| 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 |
|---|---|---|---|---|
| 1306840392 | Fountain Valley Orthotics and Prosthetics Inc. | Prosthetic/Orthotic Supplier | 623 N Main St, Orange, CA 92868-1103 | 2005-06-08 |
| 1689942294 | Active Life, Inc. | Prosthetic/Orthotic Supplier | 2140 W Chapman Ave, Suite 103, Orange, CA 92868-2331 | 2011-12-09 |
| 1326349630 | Cranial Technologies Inc | Prosthetic/Orthotic Supplier | 1010 W La Veta Ave Ste 510, St Joseph Hospital Medical Tower, Orange, CA 92868-4305 | 2010-11-03 |
| 1568617868 | Orange Coast Prosthetics Inc. | Prosthetic/Orthotic Supplier | 2324 N Batavia St, Suite 104, Orange, CA 92865-2019 | 2008-12-01 |
| 1649456187 | Ventura Prosthetics& Orthotics, Inc. | Prosthetic/Orthotic Supplier | 2324 N Batavia St, Suite 104, Orange, CA 92865-2019 | 2008-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821696592 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 3031 W March Ln Ste 216w, Stockton, CA 95219-6500 | 2020-10-14 |
| 1871191742 | Alcam Medical Inc. | Prosthetic/Orthotic Supplier | 1244 N Mariposa St Ste 10, Fresno, CA 93703-3929 | 2020-10-13 |
| 1740887462 | A-z Consulting O & P Services | Prosthetic/Orthotic Supplier | 1133 Smith Ln Ste 5, Roseville, CA 95661-4131 | 2020-10-06 |
| 1255938452 | Sheek Hair Boutique | Prosthetic/Orthotic Supplier | 1432 N Cedar Ave Apt 107, Fresno, CA 93703-5303 | 2020-10-01 |
| 1922615368 | Inland Artificial Limb & Brace | Prosthetic/Orthotic Supplier | 1101 Bryan Ave Ste C, Tustin, CA 92780-4401 | 2020-09-29 |
| 1043823461 | Crystal Johnson | Prosthetic/Orthotic Supplier | 812 S Flower St Apt 4, Inglewood, CA 90301-7913 | 2020-08-25 |
| 1225640220 | Christopher Holloway | Prosthetic/Orthotic Supplier | 4517 Market St Ste 4, Ventura, CA 93003-7841 | 2020-08-20 |
| 1407468416 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 488 E Valley Pkwy Ste 207, Escondido, CA 92025-3368 | 2020-08-20 |
| 1801406269 | Restore Medical Inc | Prosthetic/Orthotic Supplier | 1505 Soquel Dr Ste 4, Santa Cruz, CA 95065-1716 | 2020-07-31 |
| 1801404199 | Covering With Care | Prosthetic/Orthotic Supplier | 21350 Avalon Blvd Unit 5039, Carson, CA 90749-7032 | 2020-07-22 |
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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.