Procare Prosthetics & Orthotics, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

PROCARE PROSTHETICS & ORTHOTICS, INC.

Practice address

1050 N Flowood Dr
Ste C1
Flowood, MS 39232-9738

Phone

(601) 664-7004

Fax

(601) 664-7099

NPI assigned

Nov 21, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Stephen Bret Lee, CPO

Title

Owner

Phone

(601) 664-7004

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339372800000",
    "number": "1366425746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 N FLOWOOD DR",
            "address_2": "STE C1",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329738",
            "telephone_number": "601-664-7004",
            "fax_number": "601-664-7099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 N FLOWOOD DR",
            "address_2": "STE C1",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329738",
            "telephone_number": "601-664-7004",
            "fax_number": "601-664-7099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCARE PROSTHETICS & ORTHOTICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-21",
        "last_updated": "2012-06-11",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "BRET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-664-7004",
        "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": "00440983",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Flowood, MS
• Providers in Flowood, MS by specialty
• Prosthetic/Orthotic Supplier in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; 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.