Maughan Prosthetic & Orthotic South, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

PS00000183 Issued in WA

Legal business name

MAUGHAN PROSTHETIC & ORTHOTIC SOUTH, INC.

Doing business as

Maughan Prosthetic & Orthotic

Practice address

208 Lilly Rd NE
Suite a
Olympia, WA 98506-6100

Phone

(360) 338-0284

Fax

(360) 878-8492

NPI assigned

Oct 2, 2012

Last updated

Sep 14, 2021By 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

Mr. Justin M Maughan, LCPONPI 1710178041

Title

Owner/President

Phone

(253) 820-3689

Specialties & licenses 1

Addresses

Other names 1

• Maughan Prosthetic & Orthotic Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

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

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.

• Justin M Maughan, CPO

  • Prosthetist
  • Silverdale, WA
  • NPI 1710178041
  Authorized official Same address or phone

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631577600000",
    "number": "1477805315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1546",
            "city": "GRAHAM",
            "state": "WA",
            "postal_code": "983381546",
            "telephone_number": "360-447-0770",
            "fax_number": "253-875-7768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 LILLY RD NE",
            "address_2": "SUITE A",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985066100",
            "telephone_number": "360-338-0284",
            "fax_number": "360-878-8492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAUGHAN PROSTHETIC & ORTHOTIC SOUTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-02",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A",
        "authorized_official_last_name": "MAUGHAN",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "253-820-3689",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "WA",
            "license": "PS00000183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maughan Prosthetic & Orthotic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rodney Shigeo Matsubara, M.D.
• Benjamin Craig Matthews, ARNP
• David Lee Matthews, M.D.
• Carrie Ann Matyac, ARNP
• Hazel Lynn Mauch
• Megan Mauldin, BS
• Kai A Maulding, D.D.S.
• Daniele Brittney Maurer
• Lauren Noelle Maurer, LMP
• Michael Paul Maurice, R.PH.

• Prosthetic/Orthotic Supplier in Olympia, WA
• Providers in Olympia, WA by specialty
• Prosthetic/Orthotic Supplier in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.