Prosthetic One

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

PROSTHETIC ONE

Practice address

11908 Kanis Rd Ste G7
Little Rock, AR 72211-3773

Phone

(501) 916-9632

NPI assigned

Aug 16, 2018

Organization subpart

No

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

Authorized official

Name

Marcus T Baker

Title

President

Phone

(682) 323-5921

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534377600000",
    "number": "1184104309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 MATLOCK RD STE 100",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760152905",
            "telephone_number": "682-323-5921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11908 KANIS RD STE G7",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113773",
            "telephone_number": "501-916-9632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSTHETIC ONE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-16",
        "last_updated": "2018-08-16",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "682-323-5921"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Prosthetic/Orthotic Supplier in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.