North Carolina Orthotics & Prosthetics

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

NORTH CAROLINA ORTHOTICS & PROSTHETICS

Practice address

451 Ruin Creek Rd
Suite 102
Henderson, NC 27536-2878

Phone

(252) 436-2611

Fax

(252) 436-2640

NPI assigned

Nov 2, 2006

Last updated

Aug 14, 2018By 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

Cindy Johncour

Title

Owner

Phone

(919) 556-3402

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

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

Tax ID family

North Carolina Orthotics Prosthetics R2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• North Carolina Orthotics & Prosthetics R

  • Prosthetic/Orthotic Supplier
  • Raleigh, NC
  • NPI 1346315553
  NPD tax ID

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Julie Bragg, CFOM., CPED

  • Orthotic Fitter
  • Raleigh, NC
  • NPI 1093863862
  NPD (past)
• Mark Fordham, CP

  • Prosthetist
  • Henderson, NC
  • NPI 1992902266
  NPD (past)
• George J Henderson, CPO

  • Orthotist
  • Wake Forest, NC
  • NPI 1538714068
  NPD (past)
• Dennis F Hodges, CPO

  • Prosthetist
  • Raleigh, NC
  • NPI 1568054740
  NPD (past)
• Bengt Walker, LCO

  • Orthotist
  • Olympia, WA
  • NPI 1609142777
  NPD (past)

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534204800000",
    "number": "1427136845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 RUIN CREEK RD",
            "address_2": "SUITE 102",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362878",
            "telephone_number": "252-436-2611",
            "fax_number": "252-436-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 RUIN CREEK RD",
            "address_2": "SUITE 102",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362878",
            "telephone_number": "252-436-2611",
            "fax_number": "252-436-2640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CAROLINA ORTHOTICS & PROSTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2018-08-14",
        "status": "A",
        "authorized_official_last_name": "JOHNCOUR",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-556-3402"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "046KY",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7703875",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Frederick Noel Jr., M.D.
• Lequetta Lasha Norfleet, LCSW-A, CPSS-S
• Norrson Healthcare
• North Carolina in-Home Partner-VI, LLC (Maria Parham Regional Home Health)
• North Carolina Inpatient Medicine Associates PLLC
• North Central Medical Transport, Inc.
• Paul Edward Novak
• Caleb Moturi Nyamorambo
• Kevin Bruce O'Dell, MD
• Oceanic Medical Supply Inc

• Prosthetic/Orthotic Supplier in Henderson, NC
• Providers in Henderson, NC by specialty
• Prosthetic/Orthotic Supplier in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; 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.