NPIMap

Organization Active NPI

Certified Orthotic & Prosthetic, Inc

Doing business as Custom Design Orthotic & Prosthetic

  • Prosthetic/Orthotic Supplier
  • Mansfield, OH
National Provider Identifier
1467450726
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
LPO144 Issued in OH
Legal business name
CERTIFIED ORTHOTIC & PROSTHETIC, INC
Doing business as
Custom Design Orthotic & Prosthetic
Practice address
271 Cline Ave
Unit 3
Mansfield, OH 44907-1042
Phone
(419) 756-6226
Fax
(419) 756-7737
NPI assigned
Jul 12, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Steven Marshall Williams, LPO
Title
President/Practitioner
Phone
(419) 756-6226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X LPO144 OH Primary

Addresses

Primary practice location

271 Cline Ave
Unit 3
Mansfield, OH 44907-1042

Mailing address

271 Cline Ave
Unit 3
Mansfield, OH 44907-1042
Phone (419) 756-6226

Other identifiers 1

IdentifierTypeStateIssuer
2307239MedicaidOH

Other names 1

  • CUSTOM DESIGN ORTHOTIC & PROSTHETIC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Certified Orthotic Prosthetic Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

271 Cline Ave
Ste 3
Mansfield, OH 44907
Phone (419) 522-0055

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467450726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 CLINE AVE",
            "address_2": "UNIT 3",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071042",
            "telephone_number": "419-756-6226",
            "fax_number": "419-756-7737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 CLINE AVE",
            "address_2": "UNIT 3",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071042",
            "telephone_number": "419-756-6226",
            "fax_number": "419-756-7737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CERTIFIED ORTHOTIC & PROSTHETIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "MARSHALL",
        "authorized_official_title_or_position": "PRESIDENT/PRACTITIONER",
        "authorized_official_telephone_number": "419-756-6226",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "OH",
            "license": "LPO144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2307239",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CUSTOM DESIGN ORTHOTIC & PROSTHETIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mansfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.