Organization Active NPI

Otto Bock Patient Care, LLC

  • Prosthetic/Orthotic Supplier
  • Gainesville, GA
National Provider Identifier
1386345585
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
OTTO BOCK PATIENT CARE, LLC
Practice address
302 Broad St SE Ste B
Gainesville, GA 30501-3716
Phone
(770) 271-5581
NPI assigned
Mar 14, 2023
Last updated
Mar 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Authorized official

Name
Pallavi Chintapalli Nemani
Title
Compliance Officer
Phone
(512) 552-6311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

302 Broad St SE Ste B
Gainesville, GA 30501-3716

Mailing address

11809 Domain Dr Unit 400
Austin, TX 78758-3452

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230807000139 GA DME Supplier - Certified Orth/Pros/Pedorthist 2668804667 Practice locations: Gainesville, GA

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Otto Bock Patient Care, LLC302 Broad St SE, Gainesville, GA 30501-3716(770) 271-5581 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses Does not accept assignmentParticipating since Jan 13, 2023

National Provider Directory

National Provider Directory
Tax ID family
Otto Bock Patient Care LLC57 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 5

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

302 Broad St SE
Ste B
Gainesville, GA 30501

NPI Registry JSON

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

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678752000000",
    "number": "1386345585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11809 DOMAIN DR UNIT 400",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787583452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 BROAD ST SE STE B",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013716",
            "telephone_number": "770-271-5581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTTO BOCK PATIENT CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A",
        "authorized_official_last_name": "NEMANI",
        "authorized_official_first_name": "PALLAVI",
        "authorized_official_middle_name": "CHINTAPALLI",
        "authorized_official_title_or_position": "COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "512-552-6311"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.