Organization Active NPI

Positive Image Prosthetics & Orthotics, Inc.

  • Prosthetic/Orthotic Supplier
  • Savannah, GA
National Provider Identifier
1235194341
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
POSITIVE IMAGE PROSTHETICS & ORTHOTICS, INC.
Practice address
Positive Image Prosthetics & Orthotics, Inc.
5202 Waters Ave.
Savannah, GA 31404-6230
Phone
(912) 354-7500
Fax
(912) 354-7887
NPI assigned
Apr 20, 2006
Last updated
Jun 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Authorized official

Name
Mr. David M Puckett, CPO/ LPONPI 1972772325
Title
President/Owner
Phone
(912) 354-7500

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 1

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

Addresses

Primary practice location

Positive Image Prosthetics & Orthotics, Inc.
5202 Waters Ave.
Savannah, GA 31404-6230

Mailing address

Positive Image Prosthetics & Orthotics, Inc.
5202 Waters Ave.
Savannah, GA 31404-6230
Phone (912) 354-7500

Other identifiers 3

IdentifierTypeStateIssuer
000844698AMedicaidGA
003212044AMedicaidGA
DE1986MedicaidSC

National Provider Directory

National Provider Directory

Locations

5202 Waters Ave
Savannah, GA 31404
Phone (912) 350-8601

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1235194341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POSITIVE IMAGE PROSTHETICS & ORTHOTICS, INC.",
            "address_2": "5202 WATERS AVE.",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046230",
            "telephone_number": "912-354-7500",
            "fax_number": "912-354-7887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "POSITIVE IMAGE PROSTHETICS & ORTHOTICS, INC.",
            "address_2": "5202 WATERS AVE.",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046230",
            "telephone_number": "912-354-7500",
            "fax_number": "912-354-7887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POSITIVE IMAGE PROSTHETICS & ORTHOTICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-20",
        "last_updated": "2024-06-03",
        "status": "A",
        "authorized_official_last_name": "PUCKETT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "912-354-7500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPO/ LPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000844698A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003212044A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE1986",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.