Bluff Prosthetics and Orthotics LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

BLUFF PROSTHETICS AND ORTHOTICS LLC

Practice address

915 W Pine St
Poplar Bluff, MO 63901-4969

Phone

(573) 778-3700

Fax

(573) 778-3702

NPI assigned

Dec 28, 2007

Organization subpart

No

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

Authorized official

Name

Horace Hodges, CP

Title

Owner

Phone

(573) 778-3700

Specialties & licenses 1

Addresses

Other names 1

• SEMO Prosthetics & Orthotics Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

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

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636502400000",
    "number": "1497930226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 W PINE ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639014969",
            "telephone_number": "573-778-3700",
            "fax_number": "573-778-3702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 W PINE ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639014969",
            "telephone_number": "573-778-3700",
            "fax_number": "573-778-3702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUFF PROSTHETICS AND ORTHOTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-28",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A",
        "authorized_official_last_name": "HODGES",
        "authorized_official_first_name": "HORACE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-778-3700",
        "authorized_official_credential": "CP"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SEMO Prosthetics & Orthotics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Staci Blankenship, OTR/L
• Timothy Blankenship, O.D.
• Linda Kay Blasingame, APRN
• Bluff Area Therapy Center, LLC
• Bluff Home Care LLC
• Bluff Radiology Group, LLC
• Deborah Elaine Boles
• Chelsea Bolin, LCSW
• John Bollenbacher, CRNA
• Wendy N Boone

• Prosthetic/Orthotic Supplier in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Prosthetic/Orthotic Supplier in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.