Orthodomicile

Primary specialty

PodiatristTaxonomy code 213E00000X

License

1411 Issued in TX

Legal business name

ORTHODOMICILE

Practice address

5510 Summerhill Rd
Texarkana, TX 75503-1822

Phone

(903) 792-2710

NPI assigned

Sep 9, 2013

Organization subpart

No

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

Authorized official

Name

Jennifer O'Brien

Title

Billing Specialist

Phone

(816) 832-8804

Specialties & licenses 2

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Glenn G Petty, D.P.M.

  • Podiatrist
  • Texarkana, TX
  • NPI 1104861160
  NPD (past)
• Thomas Minh-Ngoc Pham, DPM

  • Podiatrist
  • Brenham, TX
  • NPI 1255740502
  NPD (past)

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

{
    "created_epoch": "1378684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378684800000",
    "number": "1245665306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5510 SUMMERHILL RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031822",
            "telephone_number": "903-792-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5510 SUMMERHILL RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031822",
            "telephone_number": "903-792-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHODOMICILE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-09",
        "last_updated": "2013-09-09",
        "status": "A",
        "authorized_official_last_name": "O'BRIEN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "816-832-8804"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "1411",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "AR",
            "license": "180",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olmm Properties, LLC.
• Ayotokunbo Olosunde, MD
• Oral and Maxillofacial Surgeons of Northeast Texas, P. a.
• Oral and Maxillofacial Surgeons of Northeast Texas, PLLC
• Orpro Inc
• Rafael F Otero, PHD
• Otm Health & Physical Therapy
• Otolaryngology and Head & Neck Surgery Associates, LLP
• Brianna Leigh Otwell, LPC INTERN
• Kouassi Adaman Ouattara, RPH

• All providers in Texarkana, TX
• Podiatrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; 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.