Certified Orthotic & Prosthetic, Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

LPO144 Issued in OH

Legal business name

CERTIFIED ORTHOTIC & PROSTHETIC, INC

Doing business as

Custom Design Orthotic & Prosthetic

Practice address

1136 Independence Ave
Marion, OH 43302-6318

Phone

(740) 383-3490

Fax

(740) 383-6459

NPI assigned

Jul 7, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Steven Marshall Williams, LPO

Title

President/Practitioner

Phone

(740) 383-3490

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CUSTOM DESIGN ORTHOTIC & PROSTHETIC Doing business as

Tax ID family

Certified Orthotic Prosthetic Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Certified Orthotic & Prosthetic, Inc

  dba Custom Design Orthotic & Prosthetic

  • Prosthetic/Orthotic Supplier
  • Ashland, OH
  • NPI 1316124423
  NPD tax ID
• Certified Orthotic & Prosthetic, Inc

  dba Custom Design Orthotic & Prosthetic

  • Prosthetic/Orthotic Supplier
  • Mansfield, OH
  • NPI 1467450726
  NPD tax ID

Locations

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386642049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 INDEPENDENCE AVE",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026318",
            "telephone_number": "740-383-3490",
            "fax_number": "740-383-6459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 INDEPENDENCE AVE",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026318",
            "telephone_number": "740-383-3490",
            "fax_number": "740-383-6459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CERTIFIED ORTHOTIC & PROSTHETIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "MARSHALL",
        "authorized_official_title_or_position": "PRESIDENT/PRACTITIONER",
        "authorized_official_telephone_number": "740-383-3490",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "OH",
            "license": "LPO144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0256431",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CUSTOM DESIGN ORTHOTIC & PROSTHETIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Prosthetic/Orthotic Supplier in Marion, OH
• Providers in Marion, OH by specialty
• Prosthetic/Orthotic Supplier in Ohio

• 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.