NPIMap

Organization Active NPI

Graybeal Orthopedic LLC

  • Prosthetic/Orthotic Supplier
  • Norton, VA
National Provider Identifier
1346958626
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
GRAYBEAL ORTHOPEDIC LLC
Practice address
450 Park PL NW Ste 101
Norton, VA 24273-2127
Phone
(276) 870-9952
Fax
(276) 444-4679
NPI assigned
Nov 7, 2022
Organization subpart
Yes
Parent organization
GRAYBEAL ORTHOPEDIC LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Authorized official

Name
Adam Lee Fann, CPO
Title
Member
Phone
(423) 975-9884

Specialties & licenses 1

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

Addresses

Primary practice location

450 Park PL NW Ste 101
Norton, VA 24273-2127

Mailing address

107 E Myrtle Ave
Johnson City, TN 37601-4631
Phone (423) 975-9884

Other identifiers 1

IdentifierTypeStateIssuer
1452173MedicaidTN

Other names 1

  • Anchor Brace and Limb Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230829001726 VA DME Supplier - Certified Orth/Pros/Pedorthist 2163542234 Practice locations: Norton, VA

Other NPIs with the same Medicare PAC ID 4

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
Graybeal Orthopedic LLC450 Park PL NW, Norton, VA 24273-2127(276) 870-9952 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Breast Prostheses and/or Accessories|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Graybeal Orthopedic LLC5 organizations share this tax ID, including this one
Part of
Graybeal Orthopedic LLC

Other organizations with this tax ID 4

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

Locations

450 Park Pl NW
Ste 101
Norton, VA 24273
Phone (276) 870-9952

NPI Registry JSON

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667779200000",
    "number": "1346958626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 E MYRTLE AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376014631",
            "telephone_number": "423-975-9884",
            "fax_number": "423-975-6678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 PARK PL NW STE 101",
            "city": "NORTON",
            "state": "VA",
            "postal_code": "242732127",
            "telephone_number": "276-870-9952",
            "fax_number": "276-444-4679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAYBEAL ORTHOPEDIC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRAYBEAL ORTHOPEDIC LLC",
        "enumeration_date": "2022-11-07",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A",
        "authorized_official_last_name": "FANN",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "423-975-9884",
        "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": "1452173",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anchor Brace and Limb",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; 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.