NPIMap

Organization Active NPI

Snell Prosthetic & Orthotic Laboratory

  • Prosthetic/Orthotic Supplier
  • North Little Rock, AR
National Provider Identifier
1063497238
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
04734178001 Issued in AR
Legal business name
SNELL PROSTHETIC & ORTHOTIC LABORATORY
Practice address
4300 Warden Rd, Ste B
North Little Rock, AR 72117
Phone
(501) 945-5462
Fax
(501) 945-1381
NPI assigned
Dec 10, 2005
Last updated
Jan 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Authorized official

Name
Brant E. Snell, LPOA
Title
Coo
Phone
(501) 664-2624

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 04734178001 AR Primary

Addresses

Primary practice location

4300 Warden Rd, Ste B
North Little Rock, AR 72117

Mailing address

625 N University Ave
Little Rock, AR 72205-2917
Phone (501) 664-2624

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930094001 AR DME Supplier - Medical Supply Company With Orthotic-ProstheticDME Supplier - Medical Supply Company With Pedorthic PersonnelDME Supplier - Pedorthic PersonnelDME Supplier - OtherDME Supplier - Prosthetic PersonnelDME Supplier - Medical Supply Company With Prosthetic PersonnelDME Supplier - Orthotic PersonnelDME Supplier - Medical Supply Company With Orthotic Personnel 8426175936 Practice locations: North Little Rock, AR

Other NPIs with the same Medicare PAC ID 10

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

National Provider Directory

National Provider Directory
Tax ID family
Snell Proth Orth Lab10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

4300 Warden Rd
Ste B
North Little Rock, AR 72116
Phone (501) 945-5462

4420 E 43rd St
North Little Rock, AR 72117
Phone (501) 945-5462

NPI Registry JSON

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

{
    "created_epoch": "1134172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704412800000",
    "number": "1063497238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 N UNIVERSITY AVE",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722052917",
            "telephone_number": "501-664-2624",
            "fax_number": "501-664-1708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 WARDEN RD, STE B",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "72117",
            "telephone_number": "501-945-5462",
            "fax_number": "501-945-1381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNELL PROSTHETIC & ORTHOTIC LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-10",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-04",
        "status": "A",
        "authorized_official_last_name": "SNELL",
        "authorized_official_first_name": "BRANT",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "501-664-2624",
        "authorized_official_credential": "LPOA"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "AR",
            "license": "04734178001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; 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.