Peds Plus Orthotics, LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

PEDS PLUS ORTHOTICS, LLC

Practice address

3851 Harrison Rd
Benton, AR 72019-9632

Phone

(501) 607-0144

Fax

(501) 794-1021

NPI assigned

Jun 24, 2015

Last updated

Jun 24, 2015By 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

Bryan Keith FlynnNPI 1962884114

Title

Owner

Phone

(501) 607-0144

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Bryan Keith Flynn

  • Orthotist
  • Benton, AR
  • NPI 1962884114
  NPD (past) Authorized official

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435104000000",
    "number": "1447632690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3851 HARRISON RD",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720199632",
            "telephone_number": "501-607-0144",
            "fax_number": "501-794-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 HARRISON RD",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720199632",
            "telephone_number": "501-607-0144",
            "fax_number": "501-794-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDS PLUS ORTHOTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-24",
        "last_updated": "2015-06-24",
        "status": "A",
        "authorized_official_last_name": "FLYNN",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-607-0144"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Peairson Jr., LCSW
• Toccara Pearson
• Pediatric Nutrition Prov of Ar (Access Pharmacy)
• Pediatric Nutrition Provider of Ar (Access Pharmacy)
• Pediatric Nutrition Provider of Arkansas (Arkansas Respiratory & Equipment Provider)
• Cathy A Pelletier, PH.D., MS, CCC-SLP
• Tyler Pennington, RECOVERY ASSISTANT
• Amaybri Perdomo
• Brenda Perkins
• Lalita H. Perkins, M.D.

• Customized Equipment (DME) in Benton, AR
• Providers in Benton, AR by specialty
• Customized Equipment (DME) in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2015; 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.