Peterman Orthotics & Prosthetics LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

588 Issued in TX

Legal business name

PETERMAN ORTHOTICS & PROSTHETICS LLC

Doing business as

Advanced Limb & Brace

Practice address

2648 34TH St
Lubbock, TX 79410-3520

Phone

(806) 783-8388

Fax

(806) 783-8956

NPI assigned

Jul 10, 2006

Last updated

Jul 31, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

HANGER INCAs reported in NPPES

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

Authorized official

Name

Ms. Grace Angeline

Title

Provider Contract Analyst III

Phone

(714) 961-2102

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• Advanced Limb & Brace Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Peterman Orthotics & Prosthetics LLC

  dba Advanced Limb & Brace

  • Prosthetic/Orthotic Supplier
  • Amarillo, TX
  • NPI 1699772046

  2769693654

  Same PAC ID

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

Tax ID family

Advanced Limb Brace2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Peterman Orthotics & Prosthetics LLC

  dba Advanced Limb & Brace

  • Prosthetic/Orthotic Supplier
  • Amarillo, TX
  • NPI 1699772046
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Hanger

  • Orthotist
  • El Paso, TX
  • NPI 1215335831
  NPPES parent name

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722384000000",
    "number": "1568496479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650846",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2648 34TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794103520",
            "telephone_number": "806-783-8388",
            "fax_number": "806-783-8956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERMAN ORTHOTICS & PROSTHETICS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HANGER INC",
        "enumeration_date": "2006-07-10",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A",
        "authorized_official_last_name": "ANGELINE",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "PROVIDER CONTRACT ANALYST III",
        "authorized_official_telephone_number": "714-961-2102",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": "588",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": "215",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": "404",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": "591",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174985503",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Limb & Brace",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Limb & Brace",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carolyn G. Perry, MS
• Dakota James Perry
• Elyse Michele Perry
• Kim E Pershall, MD
• Lauren Helen Pert, MD
• Stacy D Peters, M.S., R.D., L.D.
• Susan Delaine Peters, RDH
• Darrin Odell Peterson, O.D.
• Jayman Disean Peterson, DPT
• Phyllis Rose Peterson, PA

• Prosthetic/Orthotic Supplier in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Prosthetic/Orthotic Supplier in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.