NPIMap

Organization Active NPI

Otto Bock Orthopedic Services LLC

  • Prosthetic/Orthotic Supplier
  • Charlotte, NC
National Provider Identifier
1104206499
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
OTTO BOCK ORTHOPEDIC SERVICES LLC
Practice address
10643 Kettering Dr
Charlotte, NC 28226
Phone
(800) 736-8276
NPI assigned
Jun 2, 2015
Last updated
Oct 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Authorized official

Name
Kimberly Lewis
Title
Evp of Licensure
Phone
(512) 806-2756

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 02286 NC
Customized Equipment (DME) 332BC3200X NU
Prosthetic/Orthotic Supplier 335E00000X NU Primary
Prosthetist 224P00000X NU

Addresses

Primary practice location

10643 Kettering Dr
Charlotte, NC 28226

Mailing address

PO Box 734949
Dallas, TX 75373-4949
Phone (800) 736-8276

Other identifiers 3

IdentifierTypeStateIssuer
02396OtherNCAUSTIN NC HME LICENSURE
1104206499MedicaidNC
02286OtherNCIN STATE NC HME LICENSURE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161028002209 NC DME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Orthotic-Prosthetic 0446450837 Practice locations: Charlotte, NC

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Otto Bock Orthopedic Services LLC10643 Kettering Dr, Charlotte, NC 28226-4713(800) 736-8276 Commodes, Urinals, Bedpans|Continuous Passive Motion (CPM) Devices|Contracture Treatment Devices: Dynamic Splint|Heat & Cold Applications|Neuromuscular Elect Stimulators (NMES)/Supplies|Osteogenesis Stimulators|Pneumatic Compression Devices and/or Supplies|Traction Equipment|(TENS) Transcutaneous E… Accepts assignmentParticipating since Dec 31, 2009

National Provider Directory

National Provider Directory
Tax ID family
Otto Bock Orthopedic Services LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

10617 Kettering Dr
Ste 104
Charlotte, NC 28226

10643 Kettering Dr
Charlotte, NC 28226

NPI Registry JSON

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761091200000",
    "number": "1104206499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 734949",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753734949",
            "telephone_number": "800-736-8276",
            "fax_number": "866-642-2302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10643 KETTERING DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28226",
            "telephone_number": "800-736-8276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTTO BOCK ORTHOPEDIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-02",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "EVP OF LICENSURE",
        "authorized_official_telephone_number": "512-806-2756"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NC",
            "license": "02286",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AUSTIN NC HME LICENSURE",
            "identifier": "02396",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104206499",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN STATE NC HME LICENSURE",
            "identifier": "02286",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.