Mark Chimento, CP, LPO

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

44 Issued in OK

Practice address

13205 S 117TH East Ave
Broken Arrow, OK 74011-5203

Phone

(918) 456-3114

NPI assigned

Mar 1, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Innovative Orthotics and Prosthetics

  • Prosthetic/Orthotic Supplier
  • Tulsa, OK
  • NPI 1336128313
  NPD

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202947200000",
    "number": "1497883391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13205 S 117TH EAST AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740115203",
            "telephone_number": "918-456-3114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13205 S 117TH EAST AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740115203",
            "telephone_number": "918-456-3114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIMENTO",
        "first_name": "MARK",
        "credential": "CP, LPO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2008-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "OK",
            "license": "44",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Danielle Chavez
• Liuyi Chen, MD
• Cherokee Services
• Ashley Maree Chesser, COTA/L
• Clinton R. Childs, M.D.
• Shelby Lynn Choat, M.S., CF-SLP
• Amber Leigh Chong, M.S., CCC-SLP
• Choose Courage Counseling Services PLLC
• Christopher Yan-CHI Chow, MD
• Christina Walker Counseling, LLC

• Prosthetic/Orthotic Supplier in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Prosthetic/Orthotic Supplier in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; 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.