Artisan Orthotic Prosthetic Technologies, Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

ARTISAN ORTHOTIC PROSTHETIC TECHNOLOGIES, INC

Practice address

1813 W Harvard Ave Ste 101
Roseburg, OR 97471-2752

Phone

(877) 353-0545

Fax

(541) 391-7308

NPI assigned

May 6, 2021

Last updated

Jan 23, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

ARTISAN ORTHOTIC PROSTHETIC TECHNOLOGIES, INCAs reported in NPPES

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

Authorized official

Name

Ryan Frank Keele, CPO

Title

Owner

Phone

(541) 525-4282

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Artisan Orthotic Prosthetic Technologies Inc

  • Prosthetic/Orthotic Supplier
  • Eugene, OR
  • NPI 1740399989

  6305052200

  Same PAC ID

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

Tax ID family

Artisan Orthotic Prosthetic Technologies Inc2 organizations share this tax ID, including this one

Part of

Artisan Orthotic Prosthetic Technologies Inc

Other organizations with this tax ID 1

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

• Artisan Orthotic Prosthetic Technologies Inc

  • Prosthetic/Orthotic Supplier
  • Eugene, OR
  • NPI 1740399989
  NPD tax ID

Member of 1

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

• Synergy Medical Systems, LLC

  • Durable Medical Equipment & Medical Supplies
  • Eugene, OR
  • NPI 1720235070

  Member Of

  NPD member

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Artisan Orthotic Prosthetic Technologies Inc

  • Prosthetic/Orthotic Supplier
  • Eugene, OR
  • NPI 1740399989
  NPPES parent name

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

{
    "created_epoch": "1620259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1366026312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 CHAD DR STE 120",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974087602",
            "telephone_number": "541-391-7307",
            "fax_number": "541-391-7308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 W HARVARD AVE STE 101",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712752",
            "telephone_number": "877-353-0545",
            "fax_number": "541-391-7308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARTISAN ORTHOTIC PROSTHETIC TECHNOLOGIES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARTISAN ORTHOTIC PROSTHETIC TECHNOLOGIES, INC",
        "enumeration_date": "2021-05-06",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "KEELE",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "FRANK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-525-4282",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Prosthetic/Orthotic Supplier in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.