NPIMap

Organization Active NPI

Custom Healthcare, LLC

  • Prosthetic/Orthotic Supplier
  • Dalton, GA
National Provider Identifier
1093017642
Registry record updated Dec 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
CUSTOM HEALTHCARE, LLC
Practice address
1508 N Thornton Ave
Ste 104
Dalton, GA 30720-8516
Phone
(706) 529-7651
Fax
(706) 529-7680
NPI assigned
Dec 1, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2010

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

Authorized official

Name
Mr. James C Rogers
Title
Ceo
Phone
(423) 697-0057

Specialties & licenses 1

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

Addresses

Primary practice location

1508 N Thornton Ave
Ste 104
Dalton, GA 30720-8516

Mailing address

3700 Brainerd Rd
Chattanooga, TN 37411-3603
Phone (423) 697-0057

Other names 1

  • PPS Orthotic & Prosthetic Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Custom Healthcare12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291161600000",
    "number": "1093017642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 BRAINERD RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374113603",
            "telephone_number": "423-697-0057",
            "fax_number": "423-648-9366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 N THORNTON AVE",
            "address_2": "STE 104",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307208516",
            "telephone_number": "706-529-7651",
            "fax_number": "706-529-7680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-01",
        "last_updated": "2010-12-01",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "423-697-0057",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PPS Orthotic & Prosthetic Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dalton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; 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.