W VA Orthotic & Prosthetic Center, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

W VA ORTHOTIC & PROSTHETIC CENTER, INC.

Practice address

64 Brookshire LN
Beckley, WV 25801-6765

Phone

(304) 256-8351

Fax

(304) 256-8387

NPI assigned

Jun 27, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Audrey E Lett

Title

President/Ceo

Phone

(304) 256-8351

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

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

Locations

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154327823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 BROOKSHIRE LN",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258016765",
            "telephone_number": "304-256-8351",
            "fax_number": "304-256-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 BROOKSHIRE LN",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258016765",
            "telephone_number": "304-256-8351",
            "fax_number": "304-256-8387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W VA ORTHOTIC & PROSTHETIC CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LETT",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "304-256-8351",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0147818001",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "269736",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "W/COMP",
            "identifier": "1040111",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0147818000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Beckley, WV
• Providers in Beckley, WV by specialty
• Prosthetic/Orthotic Supplier in West Virginia

• 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.
• 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.