Orthomedical, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

DME200 Issued in ID

Legal business name

ORTHOMEDICAL, INC

Practice address

1053 W Bridge St
Blackfoot, ID 83221-1915

Phone

(208) 785-4595

Fax

(208) 785-4595

NPI assigned

Nov 22, 2006

Last updated

Dec 7, 2021By 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

Hayley Hall

Title

Owner/President

Phone

(208) 785-4595

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

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

Locations

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638835200000",
    "number": "1366517450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1127",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211127",
            "telephone_number": "208-785-4595",
            "fax_number": "208-785-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1053 W BRIDGE ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211915",
            "telephone_number": "208-785-4595",
            "fax_number": "208-785-4595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOMEDICAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "HAYLEY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "208-785-4595"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "ID",
            "license": "DME200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805979000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheyene Joseph Nickerson
• Summer Ann Nimmons, LCSW
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• Shayna Kearn Norton, LMFT, CADC
• Andrew L Olnes, MD
• Shawn B Ostler, M.D.
• Brent Stanley Packer, BS
• Packham Insurance Agency
• Palma Family Practice LLC
• Catlin A Palmer, LCSW

• Durable Medical Equipment & Medical Supplies in Blackfoot, ID
• Providers in Blackfoot, ID by specialty
• Durable Medical Equipment & Medical Supplies in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.