Nevada Orthotics & Prosthetics, Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

NEVADA ORTHOTICS & PROSTHETICS, INC

Practice address

3435 W Cheyenne Ave
Suite 102
North Las Vegas, NV 89032-8206

Phone

(702) 233-5500

Fax

(702) 233-2131

NPI assigned

Sep 9, 2009

Last updated

Oct 6, 2022By 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

Petra Thiessen, CFM

Title

Operations Manager

Phone

(702) 233-5500

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

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

• Nevada Orthotics & Prosthetics Inc

  • Prosthetic/Orthotic Supplier
  • Pahrump, NV
  • NPI 1457786543

  6709086473

  Same PAC ID
• Nevada Orthotics & Prosthetics, Inc

  • Prosthetic/Orthotic Supplier
  • Kingman, AZ
  • NPI 1487291688

  6709086473

  Same PAC ID

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

Tax ID family

Nevada Orthotics Prosthetics Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Nevada Orthotics & Prosthetics Inc

  • Prosthetic/Orthotic Supplier
  • Pahrump, NV
  • NPI 1457786543
  NPD tax ID
• Nevada Orthotics & Prosthetics, Inc

  • Prosthetic/Orthotic Supplier
  • Kingman, AZ
  • NPI 1487291688
  NPD tax ID

Locations

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

{
    "created_epoch": "1252454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665014400000",
    "number": "1255664165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 W CHEYENNE AVE",
            "address_2": "SUITE 102",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890328206",
            "telephone_number": "702-233-5500",
            "fax_number": "702-233-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 W CHEYENNE AVE",
            "address_2": "SUITE 102",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890328206",
            "telephone_number": "702-233-5500",
            "fax_number": "702-233-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEVADA ORTHOTICS & PROSTHETICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-09",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A",
        "authorized_official_last_name": "THIESSEN",
        "authorized_official_first_name": "PETRA",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "702-233-5500",
        "authorized_official_credential": "CFM"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA STATE BOARD OF PHARMACY, MEDICAL DEVICES, EQUIPTMENT, GAS LICENSE",
            "identifier": "MP00636",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS AND PROSTHETICS INC.",
            "identifier": "CPO02365",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255664165",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nevada Health Centers, Inc. (North Las Vegas Family Health Center)
• Nevada Medical Systems, Inc.
• Nevada Mentoring and Behavioral Health Services LLC
• Nevada Post-Acute Medical Services-Scherr 1 PC
• Nevada Transit Connect
• Nevada Transitional Services
• Christopher Michael Nevarez, M.D.
• Laurel Anne Neville, MD

• Prosthetic/Orthotic Supplier in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Prosthetic/Orthotic Supplier in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; 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.