Individual provider Active NPI

Seth O'Brien, CP, FAAOP

  • Prosthetist
  • Mesa, AZ
National Provider Identifier
1427317429
Registry record updated Jun 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthetistTaxonomy code 224P00000X
License
CP003902
Practice address
2058 S Dobson Rd Ste 17
Mesa, AZ 85202
Phone
(480) 969-3999
Fax
(480) 730-2750
NPI assigned
May 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetist 224P00000X CP003902 Primary

Addresses

Primary practice location

2058 S Dobson Rd Ste 17
Mesa, AZ 85202

Mailing address

2058 S Dobson Rd Ste 17
Mesa, AZ 85202-6456
Phone (480) 969-3999

Other practice location 1

7600 N 15th St Ste 105
Phoenix, AZ 85020-4330
Phone (602) 745-2080

Other identifiers 1

IdentifierTypeStateIssuer
CP003902OtherABC CERTIFICATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1336608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1427317429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2058 S DOBSON RD STE 17",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852026456",
            "telephone_number": "480-969-3999",
            "fax_number": "480-730-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2058 S DOBSON RD STE 17",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85202",
            "telephone_number": "480-969-3999",
            "fax_number": "480-730-2750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7600 N 15th St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850204330",
            "country_code": "US",
            "telephone_number": "602-745-2080",
            "fax_number": "602-745-2074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "SETH",
        "credential": "CP, FAAOP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-10",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": null,
            "license": "CP003902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ABC CERTIFICATION",
            "identifier": "CP003902",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; 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.