Advanced Anatomical Design LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

LO0208 Issued in OH

Legal business name

ADVANCED ANATOMICAL DESIGN LLC

Practice address

300 S State St
Girard, OH 44420-2951

Phone

(330) 288-0027

Fax

(330) 288-0095

NPI assigned

Sep 5, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Sean N Kratzer, LO BOCO

Title

Co President

Phone

(330) 288-0027

Specialties & licenses 4

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073615431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 W MAIN ST",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444061433",
            "telephone_number": "330-533-7207",
            "fax_number": "330-533-7991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S STATE ST",
            "city": "GIRARD",
            "state": "OH",
            "postal_code": "444202951",
            "telephone_number": "330-288-0027",
            "fax_number": "330-288-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED ANATOMICAL DESIGN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KRATZER",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CO PRESIDENT",
        "authorized_official_telephone_number": "330-288-0027",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LO BOCO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "OH",
            "license": "LO0209",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "OH",
            "license": "LPED0061",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "OH",
            "license": "LP0122",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "OH",
            "license": "LO0208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000230289",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2570918",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.