NPIMap

Organization Active NPI

Complete Care Prosthetics and Orthotics LLC

  • Prosthetic/Orthotic Supplier
  • Philadelphia, PA
National Provider Identifier
1225628670
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
COMPLETE CARE PROSTHETICS AND ORTHOTICS LLC
Practice address
600 Washington Ave Ste 18UC
Philadelphia, PA 19147-4836
Phone
(215) 298-0604
Fax
(215) 298-0608
NPI assigned
Jan 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Authorized official

Name
Abiodun Oluwagbenga Sobowale, CPONPI 1154099240
Title
Prosthetist/Orthotist
Phone
(215) 298-0604

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OrthotistGroup: 193200000X MULTI-SPECIALTY GROUP 222Z00000X
ProsthetistGroup: 193200000X MULTI-SPECIALTY GROUP 224P00000X
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

600 Washington Ave Ste 18UC
Philadelphia, PA 19147-4836

Mailing address

600 Washington Ave Ste 18UC
Philadelphia, PA 19147-4836
Phone (215) 298-0604

Other names 1

  • COMPLETE CARE PROSTHETICS AND ORTHOTICS LLC Doing business as

National Provider Directory

National Provider Directory

Locations

600 Washington Ave
#18
Philadelphia, PA 19147
Phone (215) 298-0604

600 Washington Ave
Ste 18UC
Philadelphia, PA 19147
Phone (215) 298-0604

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": "1611100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642636800000",
    "number": "1225628670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 WASHINGTON AVE STE 18UC",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191474836",
            "telephone_number": "215-298-0604",
            "fax_number": "215-298-0608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 WASHINGTON AVE STE 18UC",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191474836",
            "telephone_number": "215-298-0604",
            "fax_number": "215-298-0608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE CARE PROSTHETICS AND ORTHOTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-20",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A",
        "authorized_official_last_name": "SOBOWALE",
        "authorized_official_first_name": "ABIODUN",
        "authorized_official_middle_name": "OLUWAGBENGA",
        "authorized_official_title_or_position": "PROSTHETIST/ORTHOTIST",
        "authorized_official_telephone_number": "215-298-0604",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthotist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMPLETE CARE PROSTHETICS AND ORTHOTICS LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "COMPLETE CARE PROSTHETICS AND ORTHOTICS LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.