Terry J Supan, CPO

Primary specialty

OrthotistTaxonomy code 222Z00000X

Practice address

355 W Carpenter Street
Suite B
Springfield, IL 62702-4945

Phone

(217) 789-1450

Fax

(217) 789-1454

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1366461410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 W CARPENTER STREET",
            "address_2": "SUITE B",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627024945",
            "telephone_number": "217-789-1450",
            "fax_number": "217-789-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 W CARPENTER STREET",
            "address_2": "SUITE B",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627024945",
            "telephone_number": "217-789-1450",
            "fax_number": "217-789-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPAN",
        "first_name": "TERRY",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "CPO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthotist in Springfield, IL
• Providers in Springfield, IL by specialty
• Orthotist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.