Dickson Orthotics & Prosthetics

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

CPO02324 Issued in DE

Legal business name

DICKSON ORTHOTICS & PROSTHETICS

Practice address

127 Crestview Park Dr
Suite 104
Dickson, TN 37055-2855

Phone

(615) 740-0177

Fax

(615) 740-1154

NPI assigned

Dec 22, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Fernando Lara, CPO

Title

Owner/Cpo

Phone

(615) 740-0177

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1324512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336348800000",
    "number": "1477822336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 CRESTVIEW PARK DR",
            "address_2": "SUITE 104",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552855",
            "telephone_number": "615-740-0177",
            "fax_number": "615-740-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 CRESTVIEW PARK DR",
            "address_2": "SUITE 104",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552855",
            "telephone_number": "615-740-0177",
            "fax_number": "615-740-1154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DICKSON ORTHOTICS & PROSTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-22",
        "last_updated": "2012-05-07",
        "status": "A",
        "authorized_official_last_name": "LARA",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_title_or_position": "OWNER/CPO",
        "authorized_official_telephone_number": "615-740-0177",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "DE",
            "license": "CPO02324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4319966",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dickson Medical Equipment, Inc
• Dickson Medical Equipment, Inc.
• Dickson Operator LLC (Dickson Health and Rehab)
• Dickson Optical PC
• Dickson Orthopaedic and Sports Medicine PLLC
• Dickson Pain and Wellness PLLC
• Dickson Pediatric Dentistry PLLC
• Dickson Recovery Center, LLC
• Dickson Surgical Partners (Dickson Ambulatory Surgery Center)
• Kyle Diluzio, MD, DMD

• Customized Equipment (DME) in Dickson, TN
• Providers in Dickson, TN by specialty
• Customized Equipment (DME) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2012; 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.