NPIMap

Organization Active NPI

Colorado Orthotic & Prosthetic Services LLC

  • Prosthetic/Orthotic Supplier
  • Grand Junction, CO
National Provider Identifier
1194401448
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
COLORADO ORTHOTIC & PROSTHETIC SERVICES LLC
Practice address
2305 N 7TH St
Grand Junction, CO 81501-8117
Phone
(970) 880-9760
Fax
(970) 880-9761
NPI assigned
Jun 22, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Authorized official

Name
Tim O'Neill
Title
President
Phone
(503) 407-5408

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

2305 N 7TH St
Grand Junction, CO 81501-8117

Mailing address

126 W 5TH Ave
Denver, CO 80204-5105
Phone (720) 685-6520

Other names 1

  • Evergreen Prosthetics and Orthotics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230911001045 CO DME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 6608089396 Practice locations: Grand Junction, CO

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Evergreen Prosthetics and Orthotics2305 N 7TH St, Grand Junction, CO 81501-8117(970) 880-9760 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Somatic Prostheses|Limb Prostheses Does not accept assignmentParticipating since Jan 1, 2023

National Provider Directory

National Provider Directory
Tax ID family
Colorado Orthotic Prosthetic Services WR7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749600000000",
    "number": "1194401448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 W 5TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802045105",
            "telephone_number": "720-685-6520",
            "fax_number": "720-685-6521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 N 7TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018117",
            "telephone_number": "970-880-9760",
            "fax_number": "970-880-9761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO ORTHOTIC & PROSTHETIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-22",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A",
        "authorized_official_last_name": "O'NEILL",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-407-5408"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Prosthetics and Orthotics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Evergreen Prosthetics and Orthotics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; 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.