Rocky Mountain Artificial Limb & Brace, Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

ROCKY MOUNTAIN ARTIFICIAL LIMB & BRACE, INC

Practice address

2350 Via Caporatti Dr Ste B
Pocatello, ID 83201-5095

Phone

(208) 232-6611

Fax

(208) 232-6612

NPI assigned

Nov 28, 2006

Last updated

Sep 26, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

BULOW HOLDINGS, LLCAs reported in NPPES

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

Authorized official

Name

Bradford Gardner

Title

VP, Coo

Phone

(615) 550-8760

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

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

• Rocky Mountain Artificial Limb & Brace, Inc

  dba ForMotion Clinic

  • Prosthetic/Orthotic Supplier
  • Idaho Falls, ID
  • NPI 1265420616

  6103943295

  Same PAC ID
• Rocky Mountain Artificial Limb & Brace, Inc

  • Prosthetic/Orthotic Supplier
  • Logan, UT
  • NPI 1679630032

  6103943295

  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

Rocky Mountain Artificial Limb Brace Inc3 organizations share this tax ID, including this one

Part of

Bulow Holdings LLC

Other organizations with this tax ID 2

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

• Rocky Mountain Artificial Limb & Brace, Inc

  dba ForMotion Clinic

  • Prosthetic/Orthotic Supplier
  • Idaho Falls, ID
  • NPI 1265420616
  NPD tax ID
• Rocky Mountain Artificial Limb & Brace, Inc

  • Prosthetic/Orthotic Supplier
  • Logan, UT
  • NPI 1679630032
  NPD tax ID

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1619043783",
    "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": "2350 VIA CAPORATTI DR STE B",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015095",
            "telephone_number": "208-232-6611",
            "fax_number": "208-232-6612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN ARTIFICIAL LIMB & BRACE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BULOW HOLDINGS, LLC",
        "enumeration_date": "2006-11-28",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_title_or_position": "VP, COO",
        "authorized_official_telephone_number": "615-550-8760"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "89730",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Codie M Robertson, FNP-C
• Marlo Patrice Robertson, LCSW
• Janeane Robinson, CNP
• Jennifer L. Robinson, PA-C
• Calvin B. Rock, MD
• Rocky Mountain Behavioral Health Center
• Rocky Mountain Emergency Physicians, LLC
• Rocky Mountain Home Health and Hospice
• Rocky Mountain Home Health and Hospice
• Rocky Mountain Physician Group LLC

• Prosthetic/Orthotic Supplier in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Prosthetic/Orthotic Supplier in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.