Wooten Prosthetics Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

N/A Issued in GA

Legal business name

WOOTEN PROSTHETICS INC

Practice address

203 Medical Way
Suite B
Riverdale, GA 30274-2517

Phone

(770) 991-7128

Fax

(770) 991-7130

NPI assigned

Jun 22, 2006

Last updated

Sep 12, 2013By 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

Mr. Jan L Wooten, CP

Title

Owner/Ceo

Phone

(770) 991-7128

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378944000000",
    "number": "1154367548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 MEDICAL WAY",
            "address_2": "SUITE B",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742517",
            "telephone_number": "770-991-7128",
            "fax_number": "770-991-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 MEDICAL WAY",
            "address_2": "SUITE B",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742517",
            "telephone_number": "770-991-7128",
            "fax_number": "770-991-7130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOOTEN PROSTHETICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2013-09-12",
        "status": "A",
        "authorized_official_last_name": "WOOTEN",
        "authorized_official_first_name": "JAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "770-991-7128",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CP"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "GA",
            "license": "N/A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00317204A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joyce Wingate-Sligh
• Timothy Gene Winstead, AUD
• Dion Wolff
• Abigail Kathryn Woodard, PT, DPT
• Charles Reginald Woods III, M.D.
• Passion Wortham, MEDICAL ASSISTANT-MA
• Lidvine Wouappi Kwekam, M.D
• Wound Care Atlanta, LLC
• Luciana Renea Wright, LPC
• Richard I Wright, MD

• Prosthetic/Orthotic Supplier in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Prosthetic/Orthotic Supplier in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; 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.