Active NPI
Orthotic & Prosthetic Services Inc
- Prosthetic/Orthotic Supplier
- Medina, OH
National Provider Identifier
1083623037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- License
- LPO202
- Legal business name
- ORTHOTIC & PROSTHETIC SERVICES INC
- Practice address
- 283 E Reagan Pkwy
Medina, OH 44256-1298 - Phone
- (330) 723-6679
- Fax
- (330) 722-7727
- NPI assigned
- Aug 7, 2006
- Last updated
- May 1, 2024
- 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
- Justin Proctor, C.P.O./L.P.O.
- Title
- President/Practitioner
- Phone
- (330) 723-6679
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | LPO202 | OH | |
| Prosthetic/Orthotic Supplier | 335E00000X | LPO202 | OH | Primary |
Addresses
Primary practice location
283 E Reagan Pkwy
Medina, OH 44256-1298
Mailing address
283 E Reagan Pkwy
Medina, OH 44256-1298
Phone (330) 723-6679
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3016168 | Medicaid | OH |
National Provider Directory
National Provider DirectoryLocations
283 E Reagan Pkwy
Medina, OH 44256
Phone (330) 723-6679
2261 Warrensville Center Rd
Ste A
University Heights, OH 44118
Phone (877) 723-6679
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154908800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1714521600000",
"number": "1083623037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "283 E REAGAN PKWY",
"city": "MEDINA",
"state": "OH",
"postal_code": "442561298",
"telephone_number": "330-723-6679",
"fax_number": "330-722-7727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "283 E REAGAN PKWY",
"city": "MEDINA",
"state": "OH",
"postal_code": "442561298",
"telephone_number": "330-723-6679",
"fax_number": "330-722-7727"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ORTHOTIC & PROSTHETIC SERVICES INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-07",
"last_updated": "2024-05-01",
"certification_date": "2024-05-01",
"status": "A",
"authorized_official_last_name": "PROCTOR",
"authorized_official_first_name": "JUSTIN",
"authorized_official_title_or_position": "PRESIDENT/PRACTITIONER",
"authorized_official_telephone_number": "330-723-6679",
"authorized_official_credential": "C.P.O./L.P.O."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "OH",
"license": "LPO202",
"primary": false
},
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": "OH",
"license": "LPO202",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3016168",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Medina, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.