Tom Watson'S Prosthetics and Orthotics Lab, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

1024483 Issued in KY

Legal business name

TOM WATSON'S PROSTHETICS AND ORTHOTICS LAB, INC.

Practice address

2819 W 4TH St
Owensboro, KY 42301-0237

Phone

(270) 684-6128

Fax

(270) 684-6411

NPI assigned

Jun 6, 2006

Organization subpart

No

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

Authorized official

Name

Sumesh Saxena, CP BOCO

Title

Owner of Bionic

Phone

(219) 791-9200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Tom Watson'S Prosthetics and Orthotics Lab, Inc.

  • Prosthetic/Orthotic Supplier
  • Evansville, IN
  • NPI 1649545641

  9537286976

  Same PAC ID

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

Bionic Prosthetics and Orthotics Group2 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.

• Tom Watson'S Prosthetics and Orthotics Lab, Inc.

  • Prosthetic/Orthotic Supplier
  • Evansville, IN
  • NPI 1649545641
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Bionic Prosthetics and Orthotics Group LLC

  • Prosthetic/Orthotic Supplier
  • Bolingbrook, IL
  • NPI 1164080743

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623974400000",
    "number": "1437198322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 E LINCOLN HWY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105809",
            "telephone_number": "197-919-2002",
            "fax_number": "312-268-5389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2819 W 4TH ST",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423010237",
            "telephone_number": "270-684-6128",
            "fax_number": "270-684-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOM WATSON'S PROSTHETICS AND ORTHOTICS LAB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A",
        "authorized_official_last_name": "SAXENA",
        "authorized_official_first_name": "SUMESH",
        "authorized_official_title_or_position": "OWNER OF BIONIC",
        "authorized_official_telephone_number": "219-791-9200",
        "authorized_official_credential": "CP BOCO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "KY",
            "license": "1024483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Owensboro, KY
• Providers in Owensboro, KY by specialty
• Prosthetic/Orthotic Supplier in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; 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.