Prosthetic Orthotic & Pedorthic Associates, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

PROSTHETIC ORTHOTIC & PEDORTHIC ASSOCIATES, INC.

Practice address

1157 Madison Ave
Memphis, TN 38104-2202

Phone

(901) 276-5960

NPI assigned

Jun 4, 2006

Organization subpart

No

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

Authorized official

Name

Mr. David A Yates, CPO

Title

President

Phone

(870) 932-6436

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• POPA Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Tax ID family

Popa2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Prosthetic Orthotic & Pedorthic Associates, Inc

  • Prosthetic/Orthotic Supplier
  • Cordova, TN
  • NPI 1538106406
  NPD tax ID

Locations

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275571671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9303",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724039303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1157 MADISON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042202",
            "telephone_number": "901-276-5960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSTHETIC ORTHOTIC & PEDORTHIC ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YATES",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-932-6436",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1452004",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "POPA",
            "code": "5",
            "type": "Other 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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.