Kormylo Orthopedic Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

KORMYLO ORTHOPEDIC INC

Practice address

3906 E Flamingo Ave
Nampa, ID 83687-3102

Phone

(208) 466-4360

Fax

(208) 466-2420

NPI assigned

Jul 2, 2007

Organization subpart

No

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

Authorized official

Name

Markus A Kormylo, C.P.O.

Title

President

Phone

(208) 377-4024

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Advanced Prosthetics and Orthotics LLC2 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.

• Advanced Prosthetics and Orthotics LLC

  • Prosthetic/Orthotic Supplier
  • Boise, ID
  • NPI 1518448638
  NPD tax ID

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452211200000",
    "number": "1306043369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 N BENJAMIN LN",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048328",
            "telephone_number": "208-377-4024",
            "fax_number": "208-375-8522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3906 E FLAMINGO AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836873102",
            "telephone_number": "208-466-4360",
            "fax_number": "208-466-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KORMYLO ORTHOPEDIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-02",
        "last_updated": "2016-01-08",
        "status": "A",
        "authorized_official_last_name": "KORMYLO",
        "authorized_official_first_name": "MARKUS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-377-4024",
        "authorized_official_credential": "C.P.O."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0004044",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Kolody, PHARM.D.
• Raphael Shakur Komakech, MBBCHB
• Jason Komoda, RPH
• Nicole Kopp, LPC
• Khristopher Edward Korell
• Megan Koster, LMSW
• Cassidy O Kotte
• Breonna V Krafft-Harris, LPC
• Catherine D Kraus, LCSW
• Evgenia Kravchuk

• Prosthetic/Orthotic Supplier in Nampa, ID
• Providers in Nampa, ID by specialty
• Prosthetic/Orthotic Supplier in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; 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.