Active NPI
Adaptive Technologies, LLC
- Prosthetic/Orthotic Supplier
- Wilson, NC
National Provider Identifier
1609960962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- Legal business name
- ADAPTIVE TECHNOLOGIES, LLC
- Practice address
- 2704 Wooten Blvd SW
Wilson, NC 27893 - Phone
- (252) 291-5858
- Fax
- (252) 291-5542
- NPI assigned
- Oct 3, 2006
- Last updated
- Oct 10, 2017
- Organization subpart
- Yes
- Parent organization
- BULOW HOLDINGS, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Aaron Kratohvil
- Title
- Controller
- Phone
- (615) 550-8760
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | NU | Primary |
Addresses
Primary practice location
2704 Wooten Blvd SW
Wilson, NC 27893
Mailing address
102 Woodmont Blvd.
Suite 120
Nashville, TN 37205
Phone (615) 550-8774
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7795002 | Medicaid | NC | |
| 7795129 | Medicaid | NC | |
| 7795148 | Medicaid | NC | |
| 7795214 | Medicaid | NC | |
| 7702039 | Medicaid | NC | |
| 0414L | Other | NC | BLUE CROSS BLUE SHIELD |
| 7704336 | Medicaid | NC | |
| 7795259 | Medicaid | NC | |
| 7795286 | Medicaid | NC | |
| 7795074 | Medicaid | NC | |
| 7795310 | Medicaid | NC |
National Provider Directory
National Provider Directory- Part of
- Bulow Holdings LLC
Locations
2704 Wooten Blvd SW
Wilson, NC 27893
Phone (252) 291-5858
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Orthotist
- Wilson, NC
- NPI 1548510381
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1507593600000",
"number": "1609960962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 WOODMONT BLVD.",
"address_2": "SUITE 120",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "37205",
"telephone_number": "615-550-8774",
"fax_number": "615-454-5352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2704 WOOTEN BLVD SW",
"city": "WILSON",
"state": "NC",
"postal_code": "27893",
"telephone_number": "252-291-5858",
"fax_number": "252-291-5542"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADAPTIVE TECHNOLOGIES, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "BULOW HOLDINGS, LLC",
"enumeration_date": "2006-10-03",
"last_updated": "2017-10-10",
"status": "A",
"authorized_official_last_name": "KRATOHVIL",
"authorized_official_first_name": "AARON",
"authorized_official_title_or_position": "CONTROLLER",
"authorized_official_telephone_number": "615-550-8760"
},
"taxonomies": [
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7795002",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7795129",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7795148",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7795214",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7702039",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0414L",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7704336",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7795259",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7795286",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7795074",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7795310",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wilson, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.