NPIMap

Organization Active NPI

Preferred Prosthetics and Orthotics, Inc.

  • Prosthetic/Orthotic Supplier
  • Poland, OH
National Provider Identifier
1306027628
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
LPO23 Issued in OH
Legal business name
PREFERRED PROSTHETICS AND ORTHOTICS, INC.
Practice address
8571 Foxwood CT Ste C
Poland, OH 44514-4313
Phone
(330) 259-0265
Fax
(330) 259-0272
NPI assigned
Nov 15, 2007
Last updated
Nov 15, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Authorized official

Name
Mr. Anthony Louis Dibenedetto, LPONPI 1619931417
Title
President
Phone
(330) 259-0265

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X LPO23 OH Primary

Addresses

Primary practice location

8571 Foxwood CT Ste C
Poland, OH 44514-4313

Mailing address

8571 Foxwood CT Ste C
Poland, OH 44514-4313
Phone (330) 259-0265

Other identifiers 2

IdentifierTypeStateIssuer
000000244821OtherOHANTHEM BC/BS
2347366MedicaidOH

National Provider Directory

National Provider Directory

Locations

8571 Foxwood Ct
Ste C
Youngstown, OH 44514
Phone (330) 259-0265

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1306027628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8571 FOXWOOD CT STE C",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445144313",
            "telephone_number": "330-259-0265",
            "fax_number": "330-259-0272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8571 FOXWOOD CT STE C",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445144313",
            "telephone_number": "330-259-0265",
            "fax_number": "330-259-0272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED PROSTHETICS AND ORTHOTICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "DIBENEDETTO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-259-0265",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "OH",
            "license": "LPO23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000244821",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2347366",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; 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.