Organization Active NPI

Orthotics Specialist

  • Prosthetic/Orthotic Supplier
  • San Antonio, TX
National Provider Identifier
1083895619
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
101184 Issued in TX
Legal business name
ORTHOTICS SPECIALIST
Practice address
Orthotics Specialist Dba Hill Country Orthotics and Pro
6631 S Zarzamora St
San Antonio, TX 78211
Phone
(210) 977-0166
Fax
(210) 977-0168
NPI assigned
Nov 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Authorized official

Name
Terri Wells
Title
Director of Operations
Phone
(210) 698-9377

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 101184 TX Primary

Addresses

Primary practice location

Orthotics Specialist Dba Hill Country Orthotics and Pro
6631 S Zarzamora St
San Antonio, TX 78211

Mailing address

4242 Medical Dr Ste 2100
San Antonio, TX 78229-5641
Phone (210) 698-9377

Other identifiers 2

IdentifierTypeStateIssuer
531770OtherTXBLUE CROSS BLUE SHIELD
171115204MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930098174 TX DME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 3274736418 Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2102 Blalock Dr
Ste 102
Austin, TX 78758
Phone (512) 490-1255

12885 Research Blvd
Unit 105
Austin, TX 78750

12414 Alderbrook Dr
Ste 102
Austin, TX 78758
Phone (512) 490-1255

226 S Enterprize Pkwy
Ste 110
Corpus Christi, TX 78405
Phone (361) 445-3586

6631 S Zarzamora St
San Antonio, TX 78211
Phone (210) 977-0166

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578960000000",
    "number": "1083895619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4242 MEDICAL DR STE 2100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782295641",
            "telephone_number": "210-698-9377",
            "fax_number": "210-698-2544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ORTHOTICS SPECIALIST DBA HILL COUNTRY ORTHOTICS AND PRO",
            "address_2": "6631 S ZARZAMORA ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78211",
            "telephone_number": "210-977-0166",
            "fax_number": "210-977-0168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOTICS SPECIALIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-26",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "210-698-9377"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": "101184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "531770",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171115204",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.