FS Grand Rapids South, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

CPED3413 Issued in MI

Legal business name

FS GRAND RAPIDS SOUTH, LLC

Practice address

6750 Kalamazoo Ave SE
Suite E
Grand Rapids, MI 49508-7897

Phone

(616) 698-7200

Fax

(616) 698-7212

NPI assigned

Oct 19, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Robert L Skinner Jr., C. PED

Title

Owner

Phone

(616) 698-7200

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287446400000",
    "number": "1003126400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6750 KALAMAZOO AVE SE",
            "address_2": "SUITE E",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087897",
            "telephone_number": "616-698-7200",
            "fax_number": "616-698-7212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6750 KALAMAZOO AVE SE",
            "address_2": "SUITE E",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087897",
            "telephone_number": "616-698-7200",
            "fax_number": "616-698-7212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FS GRAND RAPIDS SOUTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-19",
        "last_updated": "2010-10-19",
        "status": "A",
        "authorized_official_last_name": "SKINNER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-698-7200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "C. PED"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "MI",
            "license": "CPED3413",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "MI",
            "license": "CPED3429",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Prosthetic/Orthotic Supplier in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.