Advance Prosthetics and Orthotics, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

POR67 Issued in FL

Legal business name

ADVANCE PROSTHETICS AND ORTHOTICS, INC.

Practice address

4537 Emerson St
Jacksonville, FL 32207-4918

Phone

(904) 858-1515

NPI assigned

Mar 2, 2006

Last updated

Jul 1, 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

Mr. Michael Dean Richard, C.P.O.

Title

President

Phone

(904) 858-1515

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625097600000",
    "number": "1386611978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4537 EMERSON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322074918",
            "telephone_number": "904-858-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4537 EMERSON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322074918",
            "telephone_number": "904-858-1515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3728 Phillips Hwy",
            "address_2": "SUITE 222",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322079300",
            "country_code": "US",
            "telephone_number": "904-858-1515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCE PROSTHETICS AND ORTHOTICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-02",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A",
        "authorized_official_last_name": "RICHARD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-858-1515",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "C.P.O."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "FL",
            "license": "POR67",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; 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.