Kustom Made LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

KUSTOM MADE LLC

Practice address

21841 Kenosha St
Oak Park, MI 48237-2651

Phone

(248) 890-9660

NPI assigned

Mar 13, 2022

Last updated

Sep 2, 2026By 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

Ms. Patrice CoatesNPI 1962840124

Title

Ceo

Phone

(248) 890-9660

Specialties & licenses 2

Addresses

Electronic endpoints 1

Practitioners 1

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.

• Patrice Coates

  • Prosthetic/Orthotic Supplier
  • Oak Park, MI
  • NPI 1962840124
  Authorized official Same address or phone

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

{
    "created_epoch": "1647129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788307200000",
    "number": "1124776828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21841 KENOSHA ST",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372651",
            "telephone_number": "248-890-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21841 KENOSHA ST",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372651",
            "telephone_number": "248-890-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KUSTOM MADE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-13",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A",
        "authorized_official_last_name": "COATES",
        "authorized_official_first_name": "PATRICE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "248-890-9660",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "info.kustommade@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "21841 Kenosha St",
            "city": "Oak Park",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482372651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Oak Park, MI
• Providers in Oak Park, MI by specialty
• Prosthetic/Orthotic Supplier in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; 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.