Innovative Prosthetic Solutions, Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

INNOVATIVE PROSTHETIC SOLUTIONS, INC

Practice address

120 Percy Hawkes Rd
Windham, ME 04062-4397

Phone

(207) 482-9874

NPI assigned

Nov 21, 2009

Last updated

Nov 21, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James W Vandersea, CPO

Title

President

Phone

(207) 482-9874

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1258761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258761600000",
    "number": "1225366792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MARGINAL WAY",
            "address_2": "#192",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012442",
            "telephone_number": "207-482-9874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PERCY HAWKES RD",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040624397",
            "telephone_number": "207-482-9874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE PROSTHETIC SOLUTIONS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-21",
        "last_updated": "2009-11-21",
        "status": "A",
        "authorized_official_last_name": "VANDERSEA",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-482-9874",
        "authorized_official_credential": "CPO"
    },
    "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 Windham, ME
• Providers in Windham, ME by specialty
• Prosthetic/Orthotic Supplier in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2009; 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.