FAMILY ORTHOTICS & PROSTHETICS INC. , NPI 1508882473 — KEARNEY (NE)

NPI 1508882473

13+ Years Experience Organization

FAMILY ORTHOTICS & PROSTHETICS INC.

07/14/2006
PROVIDER ENUMERATION DATE
06/21/2018
LAST UPDATE DATE
1508882473
NPI NUMBER

About FAMILY ORTHOTICS & PROSTHETICS INC.

FAMILY ORTHOTICS & PROSTHETICS INC. is a provider established in KEARNEY, NE. The NPI number of FAMILY ORTHOTICS & PROSTHETICS INC. is 1508882473 and was assigned on 07/14/2006. The practitioners primary taxonomy code is: 335E00000X .

Mailing address

  • City: KEARNEY
  • State: NE
  • Postal code: 688481510
  • Phone: 3083383550
  • Fax: 3083383551
  • Address: PO BOX 1510

Primary Practice Address

  • Region : KEARNEY, NE
  • NPI : 1508882473
  • Phone : 3083383550
  • Fax : 3083383551
  • Postalcode : 688451305
  • Address : 4005 7TH AVE

Additional identifiers

  • Identifier: 579268
  • Code / Type : 5 - MEDICAID
  • Identifier state : IA

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Additional identifiers # 2

  • Identifier: 8836
  • Code / Type : 1 - other
  • Identifier state : NE
  • Identifier issuer : BCBS OF NE PROV. #

Provider taxonomy - Prosthetic/Orthotic Supplier

  • Taxonomy code: 335E00000X

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: 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.

Contacts:

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  • FAMILY ORTHOTICS & PROSTHETICS INC.
  • Address : 4005 7TH AVE
  • Region : KEARNEY, NE
  • NPI : 1508882473
  • Phone : 3083383550
  • Fax : 3083383551
  • Postalcode : 688451305

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 3083383550
  • Title or position : OWNER
  • Credentials : CO, C. PED

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address4005 7TH AVE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameKEARNEY
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameNE
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code688451305
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number3083383550
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number3083383551
The fax number associated with the location address of the provider being identified.
NPI1508882473
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1335E00000X
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.
Provider Enumeration Date07/14/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated06/21/2018
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)FAMILY ORTHOTICS & PROSTHETICS INC.
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing AddressPO BOX 1510
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameKEARNEY
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameNE
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code688481510
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number3083383550
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number3083383551
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Authorized Official Last NameVYVLECKA
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameKENNETH
The first name of the authorized official
Authorized Official Title or PositionOWNER
The title or position of the authorized official
Authorized Official Name Prefix TextMR.
Authorized Official Name Prefix Text
Authorized Official Credential TextCO, C. PED
Authorized Official Credential Text
Authorized Official Telephone Number3083383550
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1335E00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Prosthetic/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.
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Other Provider Identifier 1579268
Other Provider Identifier #1
Other Provider Identifier Type 15
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1IA
Other Provider Identifier State #1
Other Provider Identifier 28836
Other Provider Identifier #2
Other Provider Identifier Type 21
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 2NE
Other Provider Identifier State #2
Other Provider Identifier Issuer 2BCBS OF NE PROV. #
Other Provider Identifier Issuer #2
X

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