NPIMap

Organization Active NPI

New Life Brace and Limb, LLC

  • Prosthetic/Orthotic Supplier
  • Webster, TX
National Provider Identifier
1497895817
Registry record updated Apr 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
C22293 Issued in TX
Legal business name
NEW LIFE BRACE AND LIMB, LLC
Practice address
250 Blossom St Ste 200
Webster, TX 77598-4243
Phone
(281) 316-5805
Fax
(281) 316-5970
NPI assigned
Feb 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2015

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

Authorized official

Name
Mr. Russell Boone
Title
Prosthetist
Phone
(281) 316-5805

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X C22293 TX Primary

Addresses

Primary practice location

250 Blossom St Ste 200
Webster, TX 77598-4243

Mailing address

250 Blossom St Ste 200
Webster, TX 77598-4243
Phone (281) 316-5805

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930071742 TX DME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 1456553023 Practice locations: Webster, TX

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
New Life Brace and Limb LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

17450 St Lukes Way
Ste 270
Conroe, TX 77384
Phone (936) 224-3160

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428969600000",
    "number": "1497895817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 BLOSSOM ST STE 200",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984243",
            "telephone_number": "281-316-5805",
            "fax_number": "281-316-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 BLOSSOM ST STE 200",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984243",
            "telephone_number": "281-316-5805",
            "fax_number": "281-316-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIFE BRACE AND LIMB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2015-04-14",
        "status": "A",
        "authorized_official_last_name": "BOONE",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "PROSTHETIST",
        "authorized_official_telephone_number": "281-316-5805",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": "C22293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; 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.