The Brace Shop, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

03179387 Issued in MD

Legal business name

THE BRACE SHOP, INC.

Practice address

8415 Bellona LN
Suite 111
Towson, MD 21204-2055

Phone

(410) 828-9791

Fax

(410) 828-9795

NPI assigned

Oct 5, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Michael Knight, CERTIFIED ORTHOTIST

Title

President

Phone

(410) 828-9791

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366538407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8415 BELLONA LN",
            "address_2": "SUITE 111",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042055",
            "telephone_number": "410-828-9791",
            "fax_number": "410-828-9795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8415 BELLONA LN",
            "address_2": "SUITE 111",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042055",
            "telephone_number": "410-828-9791",
            "fax_number": "410-828-9795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BRACE SHOP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KNIGHT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-828-9791",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CERTIFIED ORTHOTIST"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": "03179387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Towson, MD
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• Specialist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.