Ortho Medical Supply Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

13746360-004-STC Issued in UT

Legal business name

ORTHO MEDICAL SUPPLY INC

Practice address

3480 Washington Blvd Ste 107
Ogden, UT 84401-4152

Phone

(801) 528-7350

Fax

(801) 528-7355

NPI assigned

Jan 16, 2014

Organization subpart

No

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

Authorized official

Name

Mike Van JensenNPI 1942622527

Title

President

Phone

(801) 528-7350

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mike Jensen, PRES.

  • Other Technician
  • Ogden, UT
  • NPI 1942622527
  NPD (past) Authorized official

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

{
    "created_epoch": "1389830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389830400000",
    "number": "1164844791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3480 WASHINGTON BLVD STE 107",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844014152",
            "telephone_number": "801-528-7350",
            "fax_number": "801-528-7355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3480 WASHINGTON BLVD STE 107",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844014152",
            "telephone_number": "801-528-7350",
            "fax_number": "801-528-7355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHO MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-16",
        "last_updated": "2014-01-16",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "MIKE",
        "authorized_official_middle_name": "VAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-528-7350"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "UT",
            "license": "13746360-004-STC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UTAH TAX CERTIFICATE",
            "identifier": "13746360",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Optimal Health Dynamics PC
• Nicholas John Ordyna, MD
• David Lloyd Orme, M.D.
• Brisa Orozco Meza
• Diamen Orozco, CASE MANAGER
• Gracie Ortiz
• Brianna Orton
• Mark Douglas Orton, MD
• Luanne Orvis
• Milla Jane Osborne, L.P.C.

• Durable Medical Equipment & Medical Supplies in Ogden, UT
• Providers in Ogden, UT by specialty
• Durable Medical Equipment & Medical Supplies in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2014; 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.