Individual provider Active NPI

Avery Watson Strickland, CPO

  • Prosthetist
  • Brunswick, GA
National Provider Identifier
1396589479
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthetistTaxonomy code 224P00000X
License
222 Issued in GA
Practice address
105 River Way
Brunswick, GA 31520-1365
Phone
(912) 270-7682
NPI assigned
Jun 24, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthotist 222Z00000X 222 GA
Prosthetist 224P00000X 222 GA Primary

Addresses

Primary practice location

105 River Way
Brunswick, GA 31520-1365

Mailing address

105 River Way
Brunswick, GA 31520-1365
Phone (912) 270-7682

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
222GAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Isles Prosthetics & Avery Watson Strickland Sole MBR Orthotist CurrentSince Aug 1, 2024 Accepting new patients

Locations

2414 Parkwood Dr
Brunswick, GA 31520
Phone (912) 265-2810

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1719187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1396589479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 RIVER WAY",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315201365",
            "telephone_number": "912-270-7682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 RIVER WAY",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315201365",
            "telephone_number": "912-270-7682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRICKLAND",
        "first_name": "AVERY",
        "middle_name": "WATSON",
        "credential": "CPO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-24",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "GA",
            "license": "222",
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "GA",
            "license": "222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.