Gaitwell Orthotics and Pedorthics

Primary specialty

OrthotistTaxonomy code 222Z00000X

Legal business name

GAITWELL ORTHOTICS AND PEDORTHICS

Practice address

560 S Loop Rd
Edgewood, KY 41017-3405

Phone

(859) 301-0622

Fax

(513) 889-1850

NPI assigned

Jan 25, 2006

Organization subpart

No

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

Authorized official

Name

Deborah A Wallace

Title

Office Mananger

Phone

(937) 456-4800

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592438400000",
    "number": "1043280779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 N COMMERCE PARK DR STE 306",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452153188",
            "telephone_number": "513-829-2217",
            "fax_number": "513-889-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 S LOOP RD",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173405",
            "telephone_number": "859-301-0622",
            "fax_number": "513-889-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAITWELL ORTHOTICS AND PEDORTHICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-25",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANANGER",
        "authorized_official_telephone_number": "937-456-4800"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthotist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90006024",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACS WORKERS COMP",
            "identifier": "106156400",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTI PLAN",
            "identifier": "A146596",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "000000298877",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Lloyd Fritch, M.D.
• Sara Elise Fronk, OTR/L
• Isaiah Fry
• Crystal Gabbard, CRNA
• Sashenka Gabriel, MD
• Roxanne B Gall, NURSE PRACTITIONER
• Erlinda Gambito, MD
• John Ganim, MD
• Daniel Benjamin Gans, MD
• Donal D Gaynor, MD

• Orthotist in Edgewood, KY
• Providers in Edgewood, KY by specialty
• Orthotist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.