Springfield Orthopaedic & Pedorthic Services, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

SPRINGFIELD ORTHOPAEDIC & PEDORTHIC SERVICES, LLC

Practice address

2100 S Brentwood Blvd Ste a
Springfield, MO 65804-2534

Phone

(417) 888-0887

NPI assigned

Feb 25, 2008

Last updated

Oct 17, 2024By 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

Hunter Tully

Title

Ceo

Phone

(954) 621-6887

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• National Diabetes Care, LLC.

  dba National Diabetes Care

  • Durable Medical Equipment & Medical Supplies
  • Orange City, FL
  • NPI 1083367015

  Member Of

  NPD member

Locations

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.

• Kurt B. Fulk, C. PED., BOC-O, CO

  • Prosthetic/Orthotic Supplier
  • Springfield, MO
  • NPI 1811028087
  NPD (past)

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

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729123200000",
    "number": "1346419249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 S BRENTWOOD BLVD STE A",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042534",
            "telephone_number": "417-888-0887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 S BRENTWOOD BLVD STE A",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042534",
            "telephone_number": "417-888-0887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGFIELD ORTHOPAEDIC & PEDORTHIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-25",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A",
        "authorized_official_last_name": "TULLY",
        "authorized_official_first_name": "HUNTER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-621-6887"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "626363402",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Springfield Neurological Institute, L.L.C.
• Springfield Neurological Institute, L.L.C.
• Springfield Neurological Institute, L.L.C.
• Springfield Neurological Institute, L.L.C. (SNI Imaging)
• Springfield OB-GYN, LLC
• Springfield Orthotics and Prosthetics Inc (Springfield Orthopedic Services)
• Springfield Physical Medicine and Rehabilitation, Inc
• Springfield Physical Therapy
• Springfield Physical Therapy & Rehabilitation Center Inc (Physical Therapy Clinic)
• Springfield Physical Therapy&Rehabilitation Ctr.Inc. (dba Physical Therapy Clinic)

• Prosthetic/Orthotic Supplier in Springfield, MO
• Providers in Springfield, MO by specialty
• Prosthetic/Orthotic Supplier in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.