Organization Active NPI

Orthotic and Prosthetic Health

  • Durable Medical Equipment & Medical Supplies
  • Watertown, SD
National Provider Identifier
1053461863
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
ORTHOTIC AND PROSTHETIC HEALTH
Practice address
810 S Maple
Watertown, SD 57201-4859
Phone
(605) 886-3272
Fax
(218) 847-7676
NPI assigned
Jan 12, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Robert E Johansen, CO
Title
President
Phone
(605) 886-3272

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X SD Primary

Addresses

Primary practice location

810 S Maple
Watertown, SD 57201-4859

Mailing address

810 S Maple
Watertown, SD 57201-4859
Phone (605) 886-3272

Other identifiers 1

IdentifierTypeStateIssuer
9162720MedicaidSD

National Provider Directory

National Provider Directory
Tax ID family
O P Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1053461863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 S MAPLE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572014859",
            "telephone_number": "605-886-3272",
            "fax_number": "218-847-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 S MAPLE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572014859",
            "telephone_number": "605-886-3272",
            "fax_number": "218-847-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOTIC AND PROSTHETIC HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "JOHANSEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "605-886-3272",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CO"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9162720",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.