Organization Active NPI

Northern Prosthetics & Orthopedic Inc

  • Prosthetic/Orthotic Supplier
  • Rockford, IL
National Provider Identifier
1194719328
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
NORTHERN PROSTHETICS & ORTHOPEDIC INC
Practice address
2629 Charles St
Rockford, IL 61108-1608
Phone
(815) 226-0444
Fax
(815) 226-1819
NPI assigned
Sep 2, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Authorized official

Name
Mr. Erich Herbert Schulze, CPO, C.PED
Title
President
Phone
(815) 226-0444

Specialties & licenses 1

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

Addresses

Primary practice location

2629 Charles St
Rockford, IL 61108-1608

Mailing address

2629 Charles St
Rockford, IL 61108-1608
Phone (815) 226-0444

Other identifiers 2

IdentifierTypeStateIssuer
0010180001OtherILBCBS OF IL HMO
41783100MedicaidWI

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
Northern Prosthetics & Orthopedic I2629 Charles St, Rockford, IL 61108-1608(815) 226-0444 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items Accepts assignmentParticipating since Jan 18, 2000

National Provider Directory

National Provider Directory

Locations

2629 Charles St
Rockford, IL 61108
Phone (815) 226-0444

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589414400000",
    "number": "1194719328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2629 CHARLES ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611081608",
            "telephone_number": "815-226-0444",
            "fax_number": "815-226-1819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2629 CHARLES ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611081608",
            "telephone_number": "815-226-0444",
            "fax_number": "815-226-1819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN PROSTHETICS & ORTHOPEDIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-02",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A",
        "authorized_official_last_name": "SCHULZE",
        "authorized_official_first_name": "ERICH",
        "authorized_official_middle_name": "HERBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-226-0444",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPO, C.PED"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL HMO",
            "identifier": "0010180001",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41783100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.