Organization Active NPI

Orthopedic Brace Inc

  • Specialist
  • Rockledge, FL
National Provider Identifier
1023093416
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ORT 93 Issued in FL
Legal business name
ORTHOPEDIC BRACE INC
Practice address
836 Executive LN
Suite 110
Rockledge, FL 32955-3597
Phone
(321) 639-0277
Fax
(321) 639-0143
NPI assigned
Dec 8, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Karen S Wilkins, C..O.
Title
President
Phone
(321) 639-0277

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ORT 93 FL Primary

Addresses

Primary practice location

836 Executive LN
Suite 110
Rockledge, FL 32955-3597

Mailing address

836 Executive LN
Suite 110
Rockledge, FL 32955-3597
Phone (321) 639-0277

Other identifiers 1

IdentifierTypeStateIssuer
M0109OtherFLBLUE CROSS BLUE SHIELD SU

National Provider Directory

National Provider Directory

Locations

836 Executive Ln
Ste 110
Rockledge, FL 32955
Phone (321) 639-0277

NPI Registry JSON

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023093416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 EXECUTIVE LN",
            "address_2": "SUITE 110",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553597",
            "telephone_number": "321-639-0277",
            "fax_number": "321-639-0143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 EXECUTIVE LN",
            "address_2": "SUITE 110",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553597",
            "telephone_number": "321-639-0277",
            "fax_number": "321-639-0143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC BRACE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILKINS",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-639-0277",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "C..O."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ORT 93",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD SU",
            "identifier": "M0109",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.