Organization Active NPI

Anatomical Designs, Inc.

  • Prosthetic/Orthotic Supplier
  • Bridgeport, WV
National Provider Identifier
1124478854
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
NO LICENSE REQUIRED
Legal business name
ANATOMICAL DESIGNS, INC.
Practice address
8000 Jerry Dove Drive Suite 104
Bridgeport, WV 26330-0000
Phone
(724) 430-1470
Fax
(724) 430-1472
NPI assigned
Jun 14, 2016
Organization subpart
Yes
Parent organization
ANATOMICAL DESIGNS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 14, 2016

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

Authorized official

Name
Shandon Hime, CPO
Title
Ceo
Phone
(724) 430-1470

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X NO LICENSE REQUIRED Primary

Addresses

Primary practice location

8000 Jerry Dove Drive Suite 104
Bridgeport, WV 26330-0000

Mailing address

8000 Jerry Dove Drive Suite 104
Bridgeport, WV 26330-0000
Phone (724) 430-1470

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170707001929 WV DME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 0042400145 Practice locations: Bridgeport, WV

Other NPIs with the same Medicare PAC ID 2

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
Anatomical Designs Inc8000 Jerry Dove Dr, Bridgeport, WV 26330-9172(304) 841-6008 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items Does not accept assignmentParticipating since Jan 1, 2020

National Provider Directory

National Provider Directory
Tax ID family
Anatomical Designs Inc3 organizations share this tax ID, including this one
Part of
Anatomical Designs Inc

Other organizations with this tax ID 2

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

Locations

8000 Jerry Dove Dr
Ste 104
Bridgeport, WV 26330
Phone (304) 841-6008

511 Burroughs St
Ste 104
Morgantown, WV 26505
Phone (304) 284-9190

1600 Murdoch Ave
Ste 300
Parkersburg, WV 26101
Phone (304) 485-1345

NPI Registry JSON

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465862400000",
    "number": "1124478854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 JERRY DOVE DRIVE SUITE 104",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263300000",
            "telephone_number": "724-430-1470",
            "fax_number": "724-430-1472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 JERRY DOVE DRIVE SUITE 104",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263300000",
            "telephone_number": "724-430-1470",
            "fax_number": "724-430-1472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANATOMICAL DESIGNS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANATOMICAL DESIGNS, INC.",
        "enumeration_date": "2016-06-14",
        "last_updated": "2016-06-14",
        "status": "A",
        "authorized_official_last_name": "HIME",
        "authorized_official_first_name": "SHANDON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "724-430-1470",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": "NO LICENSE REQUIRED",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; 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.