Orthotic Lab

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

ORTHOTIC LAB

Practice address

800 8TH Ave Ste 536
Fort Worth, TX 76104-2604

Phone

(817) 332-5500

Fax

(817) 332-5503

NPI assigned

Aug 2, 2018

Organization subpart

Yes

Parent organization

DR KEVIN D RHODESAs reported in NPPES

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

Authorized official

Name

Dr. Kevin Rhodes, DPM

Title

Owner

Phone

(817) 332-5500

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Orthotic Lab

Locations

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

{
    "created_epoch": "1533168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533168000000",
    "number": "1063990927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 8TH AVE STE 536",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042604",
            "telephone_number": "817-332-5500",
            "fax_number": "817-332-5503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 8TH AVE STE 536",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042604",
            "telephone_number": "817-332-5500",
            "fax_number": "817-332-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOTIC LAB",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DR KEVIN D RHODES",
        "enumeration_date": "2018-08-02",
        "last_updated": "2018-08-02",
        "status": "A",
        "authorized_official_last_name": "RHODES",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-332-5500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103849906",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Customized Equipment (DME) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; 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.