North Carolina Orthotics & Prosthetics of Roanoke Rapids, Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

NORTH CAROLINA ORTHOTICS & PROSTHETICS OF ROANOKE RAPIDS, INC

Practice address

725 Hamilton St
Suite D
Roanoke Rapids, NC 27870-2746

Phone

(252) 535-0077

Fax

(252) 535-0078

NPI assigned

Oct 25, 2006

Last updated

Aug 14, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cindy Johncour

Title

Owner

Phone

(919) 556-3402

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

Practitioners 4

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.

• Michael Dicicco, BOCP, BEBOCO, CPED

  • Prosthetist
  • Roanoke Rapids, NC
  • NPI 1720498538
  NPD (past)
• Mark Fordham, CP

  • Prosthetist
  • Henderson, NC
  • NPI 1992902266
  NPD (past)
• George J Henderson, CPO

  • Orthotist
  • Wake Forest, NC
  • NPI 1538714068
  NPD (past)
• Dennis F Hodges, CPO

  • Prosthetist
  • Raleigh, NC
  • NPI 1568054740

  Orthotist

  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534204800000",
    "number": "1114002847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 LEIGHTON RIDGE DR",
            "address_2": "SUITE 100",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275875987",
            "telephone_number": "252-535-0077",
            "fax_number": "252-535-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 HAMILTON ST",
            "address_2": "SUITE D",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278702746",
            "telephone_number": "252-535-0077",
            "fax_number": "252-535-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CAROLINA ORTHOTICS & PROSTHETICS OF ROANOKE RAPIDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2018-08-14",
        "status": "A",
        "authorized_official_last_name": "JOHNCOUR",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-556-3402"
    },
    "taxonomies": [
        {
            "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": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "047C0",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7704534",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Anthony Nicholson, D.D.S.
• Margaret Greta Nicholson, LPC
• Nicole St. Clair Services
• Virginia Lelle Niver, PA
• North Carolina CVS Pharmacy LLC (CVS Pharmacy #03387)
• Northeastern Carolina Physical Therapy Inc.
• Northern Carolina Orthopaedics, PLLC
• Derlie Denise Norwood, FNP
• Kayla Zoe Odle, MD
• Moses Ohale

• Prosthetic/Orthotic Supplier in Roanoke Rapids, NC
• Providers in Roanoke Rapids, NC by specialty
• Prosthetic/Orthotic Supplier in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; 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.