Procare Prosthetics and Orthotics, Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

061187399 Issued in MS

Legal business name

PROCARE PROSTHETICS AND ORTHOTICS, INC

Practice address

1050 N Flowood Dr
C-1
Flowood, MS 39232-9738

Phone

(601) 664-7004

Fax

(601) 664-7099

NPI assigned

Aug 8, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Stephen Bret Lee, CPO

Title

President

Phone

(601) 664-7004

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583884800000",
    "number": "1205027844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 N FLOWOOD DR",
            "address_2": "SUITE C-1",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329738",
            "telephone_number": "601-664-7004",
            "fax_number": "601-664-7099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 N FLOWOOD DR",
            "address_2": "C-1",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329738",
            "telephone_number": "601-664-7004",
            "fax_number": "601-664-7099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCARE PROSTHETICS AND ORTHOTICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-08",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "BRET",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-664-7004",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "MS",
            "license": "061187399",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Flowood, MS
• Providers in Flowood, MS by specialty
• Prosthetic/Orthotic Supplier in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; 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.