Dayton Artificial Limb Clinic, Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

CPO1502 Issued in OH

Legal business name

DAYTON ARTIFICIAL LIMB CLINIC, INC

Practice address

700 Harco Dr
Clayton, OH 45315-8793

Phone

(937) 898-2200

Fax

(936) 832-5361

NPI assigned

Jun 13, 2007

Last updated

Oct 21, 2014By 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. Tracy Clay Slemker, CPO

Title

President

Phone

(937) 898-2200

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413849600000",
    "number": "1396949400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 HARCO DR",
            "city": "CLAYTON",
            "state": "OH",
            "postal_code": "453158793",
            "telephone_number": "937-898-2200",
            "fax_number": "937-832-5361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 HARCO DR",
            "city": "CLAYTON",
            "state": "OH",
            "postal_code": "453158793",
            "telephone_number": "937-898-2200",
            "fax_number": "936-832-5361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAYTON ARTIFICIAL LIMB CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2014-10-21",
        "status": "A",
        "authorized_official_last_name": "SLEMKER",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "CLAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-898-2200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "OH",
            "license": "LP0114",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "OH",
            "license": "CPO1502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2009589",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000020050",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BWC",
            "identifier": "311468023-00",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blaze Community Services LLC
• Rebecca Brand, RN
• Hillary Campbell, STNA
• Grace Patricia Counts
• Katherine L Davis, PT
• Dayton Artificial Limb Clinic, Inc.
• Dayton Pain Center LLC
• Dava J Derrick, CNP
• Fidelis Njok Elokobi, RN BSN
• Paul Frank

• Prosthetic/Orthotic Supplier in Clayton, OH
• Providers in Clayton, 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 Oct 21, 2014; 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.