Memphis Orthopaedic Medical Supplies,LLC.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

MEMPHIS ORTHOPAEDIC MEDICAL SUPPLIES,LLC.

Practice address

2809 Kirby Parkway
Suite 105
Memphis, TN 38119-8241

Phone

(901) 755-4344

Fax

(901) 755-4099

NPI assigned

Jul 13, 2005

Last updated

Sep 11, 2025By 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

Mr. Guy Fred Wallace, CO

Title

President

Phone

(901) 755-4344

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Metro Orthotics Former legal business name

Locations

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1275531220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 KIRBY PARKWAY",
            "address_2": "SUITE 105",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381198241",
            "telephone_number": "901-755-4344",
            "fax_number": "901-755-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 KIRBY PARKWAY",
            "address_2": "SUITE 105",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381198241",
            "telephone_number": "901-755-4344",
            "fax_number": "901-755-4099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMPHIS ORTHOPAEDIC MEDICAL SUPPLIES,LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-13",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "GUY",
        "authorized_official_middle_name": "FRED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-755-4344",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CO"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1452529",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "3160043",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metro Orthotics",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Prosthetic/Orthotic Supplier in Memphis, TN
• Providers in Memphis, TN by specialty
• Prosthetic/Orthotic Supplier in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.