NPIMap

Organization Active NPI

Prevail Prosthetics and Orthotics, Inc

  • Prosthetic/Orthotic Supplier
  • Greenfield, IN
National Provider Identifier
1245004795
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
PREVAIL PROSTHETICS AND ORTHOTICS, INC
Practice address
1270 N State St
Greenfield, IN 46140-1055
Phone
(463) 895-7701
Fax
(463) 895-7702
NPI assigned
Nov 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Authorized official

Name
Christi Hudson
Title
Business Manager
Phone
(260) 459-2529

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

1270 N State St
Greenfield, IN 46140-1055

Mailing address

7735 W Jefferson Blvd Ste C
Fort Wayne, IN 46804-4135
Phone (260) 483-5219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250310002583 IN DME Supplier - Medical Supply Company With Orthotic-Prosthetic 6709903263 Practice locations: Greenfield, IN

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Prevail Prosthetics and Orthotics1270 N State St, Greenfield, IN 46140-1055(463) 895-7701 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items Accepts assignmentParticipating since Jan 1, 2021

National Provider Directory

National Provider Directory
Tax ID family
Prevail Prosthetics and Orthotics Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10826 Coldwater Rd
Fort Wayne, IN 46845
Phone (260) 483-5219

1270 N State St
Greenfield, IN 46140
Phone (463) 895-7701

8345 Clearvista Pl
Unit 400
Indianapolis, IN 46256
Phone (317) 577-2273

NPI Registry JSON

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

{
    "created_epoch": "1699920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705276800000",
    "number": "1245004795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7735 W JEFFERSON BLVD STE C",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044135",
            "telephone_number": "260-483-5219",
            "fax_number": "260-203-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 N STATE ST",
            "city": "GREENFIELD",
            "state": "IN",
            "postal_code": "461401055",
            "telephone_number": "463-895-7701",
            "fax_number": "463-895-7702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVAIL PROSTHETICS AND ORTHOTICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-14",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "CHRISTI",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "260-459-2529"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.