Active NPI
Positive Image Prosthetics & Orthotics, Inc
- Prosthetic/Orthotic Supplier
- Hardeeville, SC
National Provider Identifier
1457593790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- License
- 000028
- Legal business name
- POSITIVE IMAGE PROSTHETICS & ORTHOTICS, INC
- Practice address
- 300 New River Pkwy
BLDG 6 Suite 12
Hardeeville, SC 29927-4450 - Phone
- (912) 354-7500
- Fax
- (912) 354-7887
- NPI assigned
- Apr 1, 2009
- Organization subpart
- Yes
- Parent organization
- POSITIVE IMAGE PROSTHETICS&ORTHOTICS,INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David M Puckett, LPO/CPO
- Title
- President/Owner
- Phone
- (912) 354-7500
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | 000028 | GA | Primary |
Addresses
Primary practice location
300 New River Pkwy
BLDG 6 Suite 12
Hardeeville, SC 29927-4450
Mailing address
5202 Waters Ave
Savannah, GA 31404-6230
Phone (912) 354-7500
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225227861 | Other | SC | NPI |
| 000844698A | Medicaid | GA | |
| DE1986 | Medicaid | SC | |
| 1235194341 | Other | GA | NPI |
National Provider Directory
National Provider Directory- Part of
- Ga Positive Image Inc
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238544000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1238544000000",
"number": "1457593790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5202 WATERS AVE",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314046230",
"telephone_number": "912-354-7500",
"fax_number": "912-354-7887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 NEW RIVER PKWY",
"address_2": "BLDG 6 SUITE 12",
"city": "HARDEEVILLE",
"state": "SC",
"postal_code": "299274450",
"telephone_number": "912-354-7500",
"fax_number": "912-354-7887"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "POSITIVE IMAGE PROSTHETICS & ORTHOTICS, INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "POSITIVE IMAGE PROSTHETICS&ORTHOTICS,INC",
"enumeration_date": "2009-04-01",
"last_updated": "2009-04-01",
"status": "A",
"authorized_official_last_name": "PUCKETT",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "PRESIDENT/OWNER",
"authorized_official_telephone_number": "912-354-7500",
"authorized_official_credential": "LPO/CPO"
},
"taxonomies": [
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": "GA",
"license": "000028",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1225227861",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000844698A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DE1986",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1235194341",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hardeeville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.