Central Brace Company

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

CENTRAL BRACE COMPANY

Practice address

404 Portland St
Rear Entrance Eye Research Foundation
Columbia, MO 65201-6506

Phone

(573) 874-0321

Fax

(573) 874-2003

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

Gerald Weston Benedict, B.O.C.O., C. PED.

Title

Owner/President

Phone

(573) 874-0321

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252540800000",
    "number": "1417962275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 PORTLAND ST",
            "address_2": "REAR ENTRANCE EYE RESEARCH FOUNDATION",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016506",
            "telephone_number": "573-874-0321",
            "fax_number": "573-874-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 PORTLAND ST",
            "address_2": "REAR ENTRANCE EYE RESEARCH FOUNDATION",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016506",
            "telephone_number": "573-874-0321",
            "fax_number": "573-874-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL BRACE COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2009-09-10",
        "status": "A",
        "authorized_official_last_name": "BENEDICT",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "WESTON",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "573-874-0321",
        "authorized_official_credential": "B.O.C.O., C. PED."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "628004400",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Columbia, MO
• Providers in Columbia, MO by specialty
• Prosthetic/Orthotic Supplier in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2009; 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.