Organization Active NPI

Gatewood Prosthetics Inc

  • Durable Medical Equipment & Medical Supplies
  • Columbus, GA
National Provider Identifier
1407035710
Registry record updated Oct 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
000071 Issued in GA
Legal business name
GATEWOOD PROSTHETICS INC
Practice address
2515 Old Whittlesey Rd
Suite a
Columbus, GA 31909-3020
Phone
(706) 596-8004
Fax
(706) 327-3388
NPI assigned
Nov 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2013

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

Authorized official

Name
George Gatewood, CPO,CPEDNPI 1932253101
Title
Owner,Prosthetist,Orthotist,Pedorth
Phone
(706) 596-8004

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 000071 GA Primary

Addresses

Primary practice location

2515 Old Whittlesey Rd
Suite a
Columbus, GA 31909-3020

Mailing address

PO Box 1623
Fortson, GA 31808-1623

Other identifiers 3

IdentifierTypeStateIssuer
N343442OtherGAWELLCARE
00919553AMedicaidGA
138773OtherGAPEACHSTATE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930056185 GA DME Supplier - Orthotic PersonnelDME Supplier - Prosthetic PersonnelDME Supplier - Certified Orth/Pros/PedorthistDME Supplier - Pedorthic Personnel 5890903413 Practice locations: Columbus, 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
Gatewood Prosthetics Inc2515 Old Whittlesey Rd, Columbus, GA 31909-3021(706) 596-8004 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Breast Prostheses and/or Accessories|Limb Prostheses|Diabetic Shoes/Inserts - Custom Does not accept assignmentParticipating since Mar 29, 2004

National Provider Directory

National Provider Directory

Locations

2515 Old Whittlesey Rd
Ste A
Columbus, GA 31909
Phone (706) 596-8004

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382313600000",
    "number": "1407035710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1623",
            "city": "FORTSON",
            "state": "GA",
            "postal_code": "318081623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 OLD WHITTLESEY RD",
            "address_2": "SUITE A",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319093020",
            "telephone_number": "706-596-8004",
            "fax_number": "706-327-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWOOD PROSTHETICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2013-10-21",
        "status": "A",
        "authorized_official_last_name": "GATEWOOD",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER,PROSTHETIST,ORTHOTIST,PEDORTH",
        "authorized_official_telephone_number": "706-596-8004",
        "authorized_official_credential": "CPO,CPED"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "000071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "N343442",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00919553A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEACHSTATE",
            "identifier": "138773",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2013; 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.