Northern Orthotic and Prosthetic Center

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

NORTHERN ORTHOTIC AND PROSTHETIC CENTER

Practice address

1279 S Pokegama Ave
Grand Rapids, MN 55744-4208

Phone

(218) 301-0001

Fax

(218) 301-0044

NPI assigned

Jul 15, 2014

Organization subpart

Yes

Parent organization

NORTHERN ORTHOTIC AND PROSTHETIC SERVICES CORPORATIONAs reported in NPPES

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

Authorized official

Name

Mr. Gregory John Francisco, BS,CO

Title

Orthotist/Owner

Phone

(218) 249-6250

Specialties & licenses 2

Addresses

Other names 1

• Northern Orthotic and Prosthetic Center Doing business as

Tax ID family

Northern Orthotics and Prosthetic Services Corporation3 organizations share this tax ID, including this one

Part of

Northern Orthotics and Prosthetic Services Corporation

Other organizations with this tax ID 2

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

• Northern Orthotics and Prosthetic Services Corporation

  • Prosthetic/Orthotic Supplier
  • Duluth, MN
  • NPI 1962579482
  NPD tax ID
• Northern Orthotics and Prosthetic Services Corporation

  • Prosthetic/Orthotic Supplier
  • Wausau, WI
  • NPI 1619302163
  NPD tax ID

Locations

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405987200000",
    "number": "1417364100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1279 S POKEGAMA AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557444208",
            "telephone_number": "218-301-0001",
            "fax_number": "218-301-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1279 S POKEGAMA AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557444208",
            "telephone_number": "218-301-0001",
            "fax_number": "218-301-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN ORTHOTIC AND PROSTHETIC CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHERN ORTHOTIC AND PROSTHETIC SERVICES CORPORATION",
        "enumeration_date": "2014-07-15",
        "last_updated": "2014-07-22",
        "status": "A",
        "authorized_official_last_name": "FRANCISCO",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "ORTHOTIST/OWNER",
        "authorized_official_telephone_number": "218-249-6250",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BS,CO"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Orthotic and Prosthetic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Prosthetic/Orthotic Supplier in Grand Rapids, MN
• Providers in Grand Rapids, MN by specialty
• Prosthetic/Orthotic Supplier in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.