Organization Active NPI

American Orthopedic & Prosthetics Inc.

Doing business as Evergreen Prosthetics and Orthotics, LLC

  • Prosthetic/Orthotic Supplier
  • Lafayette, IN
National Provider Identifier
1457359408
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
AMERICAN ORTHOPEDIC & PROSTHETICS INC.
Doing business as
Evergreen Prosthetics and Orthotics, LLC
Practice address
720 Farabee CT
Lafayette, IN 47905-5917
Phone
(765) 447-0111
NPI assigned
Jul 13, 2005
Last updated
Mar 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Authorized official

Name
Brian Martin Creighton, BOCPO CTPO
Title
President
Phone
(765) 447-0111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

720 Farabee CT
Lafayette, IN 47905-5917

Mailing address

720 Farabee CT
Lafayette, IN 47905-5917
Phone (765) 447-0111

Other identifiers 2

IdentifierTypeStateIssuer
100175540MedicaidIN
000000097257OtherINBLUE CROSS BLUE SHIELD

Other names 1

  • Evergreen Prosthetics and Orthotics, LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930000004 IN DME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 9133245715 Practice locations: Lafayette, IN

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Evergreen Prosthetics & Orthotics720 Farabee CT, Lafayette, IN 47905-5917(765) 447-0111 Neuromuscular Elect Stimulators (NMES)/Supplies|Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Facial Prostheses|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory

Locations

720 Farabee Ct
Lafayette, IN 47905
Phone (765) 447-0111

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742169600000",
    "number": "1457359408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 FARABEE CT",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055917",
            "telephone_number": "765-447-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 FARABEE CT",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055917",
            "telephone_number": "765-447-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN ORTHOPEDIC & PROSTHETICS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-13",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A",
        "authorized_official_last_name": "CREIGHTON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "765-447-0111",
        "authorized_official_credential": "BOCPO CTPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100175540",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000097257",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Prosthetics and Orthotics, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; 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.