Active NPI
Southeast Alaska Prosthetics and Orthotics LLC
- Prosthetic/Orthotic Supplier
- Ketchikan, AK
National Provider Identifier
1376711549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- Legal business name
- SOUTHEAST ALASKA PROSTHETICS AND ORTHOTICS LLC
- Practice address
- 5193 Borch St
Ketchikan, AK 99901-9036 - Phone
- (907) 254-1276
- Fax
- (907) 247-7868
- NPI assigned
- Feb 11, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Elizabeth Einset, CPO
- Title
- Owner
- Phone
- (907) 254-1276
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | AK | Primary |
Addresses
Primary practice location
5193 Borch St
Ketchikan, AK 99901-9036
Mailing address
PO Box 7561
Ketchikan, AK 99901-2561
Phone (907) 254-1276
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930081261 | AK | DME Supplier - Orthotic Personnel | 4880807015 |
1 other NPI on this enrollment Practice locations: Ketchikan, AK |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202688000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1331769600000",
"number": "1376711549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7561",
"city": "KETCHIKAN",
"state": "AK",
"postal_code": "999012561",
"telephone_number": "907-254-1276",
"fax_number": "907-247-7868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5193 BORCH ST",
"city": "KETCHIKAN",
"state": "AK",
"postal_code": "999019036",
"telephone_number": "907-254-1276",
"fax_number": "907-247-7868"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHEAST ALASKA PROSTHETICS AND ORTHOTICS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-02-11",
"last_updated": "2012-03-15",
"status": "A",
"authorized_official_last_name": "EINSET",
"authorized_official_first_name": "ELIZABETH",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "907-254-1276",
"authorized_official_credential": "CPO"
},
"taxonomies": [
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": "AK",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ketchikan, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.