Organization Active NPI

Southeast Alaska Prosthetics and Orthotics LLC

  • Prosthetic/Orthotic Supplier
  • Ketchikan, AK
National Provider Identifier
1376711549
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
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

Updated by the provider on Mar 15, 2012

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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
O20100930081261 AK DME Supplier - Orthotic PersonnelDME Supplier - Prosthetic 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 Directory

NPI 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.

Verify at the official NPI Registry.