Organization Active NPI

The Brace Place Inc.

  • Durable Medical Equipment & Medical Supplies
  • Lubbock, TX
National Provider Identifier
1477596724
Registry record updated May 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
0011 Issued in TX
Legal business name
THE BRACE PLACE INC.
Practice address
3719 24TH St
Lubbock, TX 79410-2015
Phone
(806) 792-0395
Fax
(806) 792-0396
NPI assigned
Jun 14, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Timothy Ladd Spradling, CONPI 1942561139
Title
Orthotist/President
Phone
(806) 792-0395

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Corporate family (same tax ID) 1

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

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20100930035634 TX DME Supplier - Orthotic PersonnelDME Supplier - Medical Supply Company With Orthotic PersonnelDME Supplier - Medical Supply Company With Orthotic-ProstheticDME Supplier - Medical Supply CompanyDME Supplier - Prosthetic Personnel 3870613615 Practice locations: Lubbock, TX

National Provider Directory

National Provider Directory
Tax ID family
The Brace Place DME (2 organizations share this tax ID)

Locations

3719 24th St
Lubbock, TX 79410
Phone (806) 792-0395

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 0011 TX Primary
Prosthetic/Orthotic Supplier 335E00000X 0011 TX

Addresses

NPPES NPI Registry

Primary practice location

3719 24TH St
Lubbock, TX 79410-2015

Mailing address

3719 24TH St
Lubbock, TX 79410-2015
Phone (806) 792-0395

Other identifiers 4

NPPES NPI Registry
IdentifierTypeStateIssuer
010018201MedicaidTX
106490100OtherTXFIRSTCARE
519091OtherTXBLUE CROSS BLUE SHIELD
R3872OtherNMNM MEDICAID (CONSULTEC)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 11, 2012.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336694400000",
    "number": "1477596724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3719 24TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794102015",
            "telephone_number": "806-792-0395",
            "fax_number": "806-792-0396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3719 24TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794102015",
            "telephone_number": "806-792-0395",
            "fax_number": "806-792-0396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BRACE PLACE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2012-05-11",
        "status": "A",
        "authorized_official_last_name": "SPRADLING",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "LADD",
        "authorized_official_title_or_position": "ORTHOTIST/PRESIDENT",
        "authorized_official_telephone_number": "806-792-0395",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CO"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "0011",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": "0011",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010018201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE",
            "identifier": "106490100",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "519091",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NM MEDICAID (CONSULTEC)",
            "identifier": "R3872",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.