Prosthetic Development and Research, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

1428 Issued in IL

Legal business name

PROSTHETIC DEVELOPMENT AND RESEARCH, INC.

Practice address

1 Mercado St
Ste. 203
Durango, CO 81301-7300

Phone

(970) 259-9258

Fax

(970) 385-7262

NPI assigned

Jul 9, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Timothy John Obrien, C.P.O.

Title

President

Phone

(970) 259-9258

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• San Juan Prosthetics and Orthotics, LLC Doing business as

Locations

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104859248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MERCADO ST",
            "address_2": "STE. 203",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017300",
            "telephone_number": "970-259-9258",
            "fax_number": "970-385-7262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MERCADO ST",
            "address_2": "STE. 203",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017300",
            "telephone_number": "970-259-9258",
            "fax_number": "970-385-7262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSTHETIC DEVELOPMENT AND RESEARCH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OBRIEN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "970-259-9258",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "C.P.O."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "IL",
            "license": "1428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08002149",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Juan Prosthetics and Orthotics, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emily Prigmore, LSW
• Amanda L Prince
• John D Prince, PA
• Prohab Physical Therapy PC
• Taylor Pronozuk, ND
• Lisa Ann Proulx
• Sarah Puckett
• Tiffany Purcell
• Julie Pysklo, MD
• Katherine Ann Pytte, LPC

• Prosthetic/Orthotic Supplier in Durango, CO
• Providers in Durango, CO by specialty
• Prosthetic/Orthotic Supplier in Colorado

• 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.