Southern Prosthetic Care LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

SOUTHERN PROSTHETIC CARE LLC

Practice address

4201 Highway 11 N Ste D
Picayune, MS 39466

Phone

(228) 216-0528

Fax

(769) 242-2556

NPI assigned

Aug 22, 2017

Organization subpart

No

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

Authorized official

Name

William J Kenny, CPNPI 1750833786

Title

Owner

Phone

(228) 216-0528

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William J. Kenny, CP

  • Prosthetist
  • Picayune, MS
  • NPI 1750833786
  NPD Authorized official

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

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1205352127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 HIGHWAY 11 N STE D",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394662014",
            "telephone_number": "228-216-0528",
            "fax_number": "769-242-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 HIGHWAY 11 N STE D",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "39466",
            "telephone_number": "228-216-0528",
            "fax_number": "769-242-2556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN PROSTHETIC CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-22",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KENNY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "228-216-0528",
        "authorized_official_credential": "CP"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa A Smith, LPC
• Penelope Smith, LMT
• Christopher L Sones, NP-C
• Southern Bone & Joint Specialists, PA
• Southern Physical Therapy Clinic, Inc.
• Sandra Janell Spiers, NP
• Paula K Spooner, LCSW
• St Joseph Hospice & Palliative Care Northshore LLC
• Stanek Chiro Services Inc
• Kathryn G Stanek, DC

• Prosthetic/Orthotic Supplier in Picayune, MS
• Providers in Picayune, 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 Jul 21, 2022; 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.