NPIMap

Organization Active NPI

Xtreme Prosthetics, LLC.

Doing business as ForMotion Clinic

  • Prosthetic/Orthotic Supplier
  • Pikeville, KY
National Provider Identifier
1104613975
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
XTREME PROSTHETICS, LLC.
Doing business as
ForMotion Clinic
Practice address
207 Hibbard St Ste 1
Pikeville, KY 41501-4792
Phone
(606) 506-1250
NPI assigned
Apr 23, 2025
Last updated
Oct 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Authorized official

Name
Bradford Gardner
Title
Coo
Phone
(615) 864-8783

Specialties & licenses 1

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

Addresses

Primary practice location

207 Hibbard St Ste 1
Pikeville, KY 41501-4792

Mailing address

102 Woodmont Blvd Ste 400
Nashville, TN 37205-5217
Phone (615) 864-8790

Other names 1

  • ForMotion Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Alabama Artificial Limb Orthopedic Service9 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

207 Hibbard St
Ste 1
Pikeville, KY 41501
Phone (606) 506-1250

NPI Registry JSON

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

{
    "created_epoch": "1745366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761004800000",
    "number": "1104613975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOODMONT BLVD STE 400",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372055217",
            "telephone_number": "615-864-8790",
            "fax_number": "615-864-8790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 HIBBARD ST STE 1",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415014792",
            "telephone_number": "606-506-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "XTREME PROSTHETICS, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-23",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "615-864-8783"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ForMotion Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pikeville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2025; 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.