Organization Active NPI

Hittenberger Orthotics and Prosthetics, LLC

  • Prosthetic/Orthotic Supplier
  • Petaluma, CA
National Provider Identifier
1578615746
Registry record updated May 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
CPO 1093 Issued in DE
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

Updated by the provider on May 20, 2016

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
4129830001OtherCAPTAN PETALUMA
412983006OtherCAPTAN SANTA ROSA
412983007OtherCAPTAN KENTFIELD
GXC000120MedicaidCA

Other names 1

  • Drew Hittenberger and Associates Doing business as

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.