Northern Orthopedic Laboratory, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

NORTHERN ORTHOPEDIC LABORATORY, INC.

Practice address

500 State St
Ogdensburg, NY 13669-2632

Phone

(315) 393-4502

Fax

(315) 393-4653

NPI assigned

Feb 5, 2007

Last updated

Aug 2, 2013By 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

Mr. Donald W Holmes, CPO

Title

President

Phone

(315) 782-9079

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Other NPIs with the same Medicare PAC ID 3

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

• Northern Orthopedic Laboratory Inc.

  • Prosthetic/Orthotic Supplier
  • Potsdam, NY
  • NPI 1154964955

  8527185107

  Same PAC ID
• Northern Orthopedic Laboratory Inc.

  • Prosthetic/Orthotic Supplier
  • Canton, NY
  • NPI 1659731388

  8527185107

  Same PAC ID
• Northern Orthopedic Laboratory, Inc.

  • Prosthetic/Orthotic Supplier
  • Watertown, NY
  • NPI 1154460327

  8527185107

  Same PAC ID

Tax ID family

Northern Orthopedic Lab5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

• Northern Orthopedic Laboratory Inc.

  • Prosthetic/Orthotic Supplier
  • Potsdam, NY
  • NPI 1154964955
  NPD tax ID
• Northern Orthopedic Laboratory Inc.

  • Prosthetic/Orthotic Supplier
  • Canton, NY
  • NPI 1659731388
  NPD tax ID
• Northern Orthopedic Laboratory, Inc.

  • Prosthetic/Orthotic Supplier
  • Syracuse, NY
  • NPI 1124167309
  NPD tax ID
• Northern Orthopedic Laboratory, Inc.

  • Prosthetic/Orthotic Supplier
  • Watertown, NY
  • NPI 1154460327
  NPD tax ID

Locations

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375401600000",
    "number": "1336288513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 STATE ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136692632",
            "telephone_number": "315-393-4502",
            "fax_number": "315-393-4653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 STATE ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136692632",
            "telephone_number": "315-393-4502",
            "fax_number": "315-393-4653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN ORTHOPEDIC LABORATORY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2013-08-02",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-782-9079",
        "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": "02063394",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Danielle Noyes, LMSW
• Doris Anne Nugent
• Monica M Nuyens, MD

• Prosthetic/Orthotic Supplier in Ogdensburg, NY
• Providers in Ogdensburg, NY by specialty
• Prosthetic/Orthotic Supplier in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.