Organization Active NPI

Mobile Prosthetics & Orthotics, Inc.

  • Prosthetic/Orthotic Supplier
  • Tampa, FL
National Provider Identifier
1073030623
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
MOBILE PROSTHETICS & ORTHOTICS, INC.
Practice address
4809 Memorial Hwy Ste 100
Tampa, FL 33634-7515
Phone
(386) 245-7770
NPI assigned
Aug 24, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Authorized official

Name
Ms. Stephanie Kingston
Title
Coo
Phone
(407) 245-7770

Specialties & licenses 1

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

Addresses

Primary practice location

4809 Memorial Hwy Ste 100
Tampa, FL 33634-7515

Mailing address

3160 Southgate Commerce Blvd Ste 38
Orlando, FL 32806-8557
Phone (407) 245-7770

Other identifiers 1

IdentifierTypeStateIssuer
001590300MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Mobile Prosthetics Orthotics Inc2 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": "1503532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614038400000",
    "number": "1073030623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3160 SOUTHGATE COMMERCE BLVD STE 38",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328068557",
            "telephone_number": "407-245-7770",
            "fax_number": "407-245-7727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4809 MEMORIAL HWY STE 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336347515",
            "telephone_number": "386-245-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE PROSTHETICS & ORTHOTICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-24",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A",
        "authorized_official_last_name": "KINGSTON",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "407-245-7770",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001590300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; 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.