NPIMap

Organization Active NPI

Stubbs Prosthetics & Orthotics, Inc.

  • Prosthetic/Orthotic Supplier
  • Chattanooga, TN
National Provider Identifier
1053395780
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
STUBBS PROSTHETICS & ORTHOTICS, INC.
Practice address
5715 Uptain Rd
Suite 5800
Chattanooga, TN 37411-5511
Phone
(423) 698-1778
Fax
(423) 698-1741
NPI assigned
Dec 6, 2005
Last updated
Aug 13, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Authorized official

Name
Melanie Stubbs
Title
Cfo
Phone
(423) 698-1778

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

5715 Uptain Rd
Suite 5800
Chattanooga, TN 37411-5511

Mailing address

5715 Uptain Rd
Suite 5800
Chattanooga, TN 37411-5511
Phone (423) 698-1778

Other identifiers 3

IdentifierTypeStateIssuer
3541423MedicaidTN
000244483AOtherGAMEDICAID
15523OtherTNBCBST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930086238 TN DME Supplier - Medical Supply Company With Orthotic-ProstheticDME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 7911023601 Practice locations: Chattanooga, TN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Stubbs Prosthetics Orthotics Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565654400000",
    "number": "1053395780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5715 UPTAIN RD",
            "address_2": "SUITE 5800",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374115511",
            "telephone_number": "423-698-1778",
            "fax_number": "423-698-1741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5715 UPTAIN RD",
            "address_2": "SUITE 5800",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374115511",
            "telephone_number": "423-698-1778",
            "fax_number": "423-698-1741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STUBBS PROSTHETICS & ORTHOTICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-06",
        "last_updated": "2019-08-13",
        "status": "A",
        "authorized_official_last_name": "STUBBS",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "423-698-1778"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3541423",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "000244483A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST",
            "identifier": "15523",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.