Orthotic Prosthetic Design, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

#51 Issued in AL

Legal business name

ORTHOTIC PROSTHETIC DESIGN, LLC

Practice address

1061 Martin Luther King Jr Blvd
Northport, AL 35476-4035

Phone

(205) 248-2193

Fax

(205) 248-2195

NPI assigned

Apr 27, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Mark Edward Smith, CO, BOCO

Title

Managing Member

Phone

(205) 248-2193

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083671606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 MARTIN LUTHER KING JR BLVD",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354764035",
            "telephone_number": "205-248-2193",
            "fax_number": "205-248-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 MARTIN LUTHER KING JR BLVD",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354764035",
            "telephone_number": "205-248-2193",
            "fax_number": "205-248-2195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOTIC PROSTHETIC DESIGN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "205-248-2193",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CO, BOCO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "AL",
            "license": "#51",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Northport, AL
• Providers in Northport, AL by specialty
• Prosthetic/Orthotic Supplier in Alabama

• 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.