Active NPI
Hittenberger Orthotics and Prosthetics, LLC
- Prosthetic/Orthotic Supplier
- Petaluma, CA
National Provider Identifier
1578615746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- License
- CPO 1093
- Legal business name
- HITTENBERGER ORTHOTICS AND PROSTHETICS, LLC
- Doing business as
- Drew Hittenberger and Associates
- Practice address
- 181 Lynch Creek Way
Suite 101
Petaluma, CA 94954-2372 - Phone
- (707) 765-1122
- NPI assigned
- Jan 17, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Drew Arnold Hittenberger, C.P.
- Title
- Owner
- Phone
- (707) 765-1122
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | CPO 1093 | DE | Primary |
Addresses
Primary practice location
181 Lynch Creek Way
Suite 101
Petaluma, CA 94954-2372
Mailing address
181 Lynch Creek Way
Suite 101
Petaluma, CA 94954-2372
Phone (707) 765-1122
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4129830001 | Other | CA | PTAN PETALUMA |
| 412983006 | Other | CA | PTAN SANTA ROSA |
| 412983007 | Other | CA | PTAN KENTFIELD |
| GXC000120 | Medicaid | CA |
Other names 1
- Drew Hittenberger and Associates
National Provider Directory
National Provider DirectoryLocations
181 Lynch Creek Way
Ste 101
Petaluma, CA 94954
Phone (707) 765-1122
500 Doyle Park Dr
Ste 106B
Santa Rosa, CA 95405
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1463702400000",
"number": "1578615746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "181 LYNCH CREEK WAY",
"address_2": "SUITE 101",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949542372",
"telephone_number": "707-765-1122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "181 LYNCH CREEK WAY",
"address_2": "SUITE 101",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949542372",
"telephone_number": "707-765-1122"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HITTENBERGER ORTHOTICS AND PROSTHETICS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-17",
"last_updated": "2016-05-20",
"status": "A",
"authorized_official_last_name": "HITTENBERGER",
"authorized_official_first_name": "DREW",
"authorized_official_middle_name": "ARNOLD",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "707-765-1122",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "C.P."
},
"taxonomies": [
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": "DE",
"license": "CPO 1093",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN PETALUMA",
"identifier": "4129830001",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN SANTA ROSA",
"identifier": "412983006",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN KENTFIELD",
"identifier": "412983007",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GXC000120",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Drew Hittenberger and Associates",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Petaluma, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.