NPIMap

Organization Active NPI

Medical Center Orthotics and Prosthetics, LLC

  • Prosthetic/Orthotic Supplier
  • Greenville, SC
National Provider Identifier
1306418892
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
MEDICAL CENTER ORTHOTICS AND PROSTHETICS, LLC
Practice address
440 Roper Mountain Rd Ste G2
Greenville, SC 29615-4235
Phone
(864) 646-0029
Fax
(864) 646-0039
NPI assigned
Jul 14, 2021
Last updated
May 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Authorized official

Name
Bradford Neil Gardner
Title
Director
Phone
(615) 864-8783

Specialties & licenses 1

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

Addresses

Primary practice location

440 Roper Mountain Rd Ste G2
Greenville, SC 29615-4235

Mailing address

102 Woodmont Blvd Ste 400
Nashville, TN 37205-5217
Phone (615) 864-8790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211117000180 SC DME Supplier - Prosthetic PersonnelDME Supplier - Medical Supply Company With Orthotic-Prosthetic 9830304427 Practice locations: Greenville, SC

Other NPIs with the same Medicare PAC ID 9

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

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Greenville440 Roper Mountain Rd, Greenville, SC 29615-4235(864) 646-0029 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom Does not accept assignmentParticipating since Jan 2, 2003

National Provider Directory

National Provider Directory
Tax ID family
Medical Center Orthotics and Prosthetics LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

3232 Georgia Ave NW
Ste 103
Washington, DC 20010
Phone (202) 507-8027

500 Lincoln St
Ste 200
Boston, MA 02134
Phone (617) 208-8468

2012 Renard Ct
Annapolis, MD 21401
Phone (410) 573-2374

1531 S Edgewood St
Ste B
Baltimore, MD 21227
Phone (410) 800-4730

6060 Piedmont Row Dr S
Ste 320
Charlotte, NC 28287
Phone (301) 585-5347

440 Roper Mountain Rd
Ste G2
Greenville, SC 29615
Phone (864) 646-0029

8330 Professional Hill Dr
Fairfax, VA 22031
Phone (703) 698-5007

NPI Registry JSON

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779926400000",
    "number": "1306418892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOODMONT BLVD STE 400",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372055217",
            "telephone_number": "615-864-8790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 ROPER MOUNTAIN RD STE G2",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154235",
            "telephone_number": "864-646-0029",
            "fax_number": "864-646-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER ORTHOTICS AND PROSTHETICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-14",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_middle_name": "NEIL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-864-8783"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; 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.