Prosthetic Care, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

000032 Issued in GA

Legal business name

PROSTHETIC CARE, LLC

Doing business as

Procare Prosthetics and Orthotics

Practice address

1135 Prince Ave
Athens, GA 30606-2729

Phone

(770) 271-5581

Fax

(770) 271-5531

NPI assigned

May 7, 2015

Last updated

Jan 25, 2023By 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

Pallavi Chintapalli Nemani

Title

Compliance Officer

Phone

(512) 552-6311

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• PROCARE PROSTHETICS AND ORTHOTICS Doing business as

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

{
    "created_epoch": "1430956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1316325657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4460 COMMERCE DR",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305183489",
            "telephone_number": "770-271-5581",
            "fax_number": "770-271-5531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 PRINCE AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062729",
            "telephone_number": "770-271-5581",
            "fax_number": "770-271-5531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSTHETIC CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-07",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "NEMANI",
        "authorized_official_first_name": "PALLAVI",
        "authorized_official_middle_name": "CHINTAPALLI",
        "authorized_official_title_or_position": "COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "512-552-6311"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "GA",
            "license": "000032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00678345A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DUN",
            "identifier": "931851232",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROCARE PROSTHETICS AND ORTHOTICS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PROCARE PROSTHETICS AND ORTHOTICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Prosthetic/Orthotic Supplier in Athens, GA
• Providers in Athens, GA by specialty
• Prosthetic/Orthotic Supplier in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.