Active NPI
Canton Orthotic Laboratory Inc
- Prosthetic/Orthotic Supplier
- Massillon, OH
National Provider Identifier
1073576617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- Legal business name
- CANTON ORTHOTIC LABORATORY INC
- Practice address
- 2400 Wales Ave NW
Suite H
Massillon, OH 44646-0804 - Phone
- (330) 833-0955
- Fax
- (330) 833-0980
- NPI assigned
- Apr 6, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Stephen Thomas Simko I
- Title
- President/Licensed Orthotist
- Phone
- (330) 833-0955
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Customized Equipment (DME) | 332BC3200X | |||
| Prosthetic/Orthotic Supplier | 335E00000X | Primary |
Addresses
Primary practice location
2400 Wales Ave NW
Suite H
Massillon, OH 44646-0804
Mailing address
2400 Wales Ave NW
Suite H
Massillon, OH 44646-0804
Phone (330) 833-0955
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000155415 | Other | OH | ANTHEM COMMUNITY MUTUAL |
| 0291143 | Medicaid | OH |
National Provider Directory
National Provider Directory- Tax ID family
- Canton Orthotic Laboratory Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Prosthetic/Orthotic Supplier
- Canton, OH
- NPI 1720080005
Locations
2400 Wales Ave NW
Ste H
Massillon, OH 44646
Phone (330) 833-0955
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144281600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1073576617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 WALES AVE NW",
"address_2": "SUITE H",
"city": "MASSILLON",
"state": "OH",
"postal_code": "446460804",
"telephone_number": "330-833-0955",
"fax_number": "330-833-0980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 WALES AVE NW",
"address_2": "SUITE H",
"city": "MASSILLON",
"state": "OH",
"postal_code": "446460804",
"telephone_number": "330-833-0955",
"fax_number": "330-833-0980"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CANTON ORTHOTIC LABORATORY INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-06",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "SIMKO",
"authorized_official_first_name": "STEPHEN",
"authorized_official_middle_name": "THOMAS",
"authorized_official_title_or_position": "PRESIDENT/LICENSED ORTHOTIST",
"authorized_official_telephone_number": "330-833-0955",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "I"
},
"taxonomies": [
{
"code": "332BC3200X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
"state": null,
"license": null,
"primary": false
},
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM COMMUNITY MUTUAL",
"identifier": "000000155415",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0291143",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Massillon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.