Creative Custom Foot Orthotics, LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

CREATIVE CUSTOM FOOT ORTHOTICS, LLC

Practice address

5500 E Yale Ave Ste 110
Denver, CO 80222-6930

Phone

(303) 669-3771

Fax

(303) 382-4600

NPI assigned

May 25, 2023

Organization subpart

No

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

Authorized official

Name

Andrew D. Kelly, BOCPD

Title

Owner/Practitioner

Phone

(303) 669-3771

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684972800000",
    "number": "1619669793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 E YALE AVE STE 110",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802226930",
            "telephone_number": "303-669-3771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 E YALE AVE STE 110",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802226930",
            "telephone_number": "303-669-3771",
            "fax_number": "303-382-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE CUSTOM FOOT ORTHOTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER/PRACTITIONER",
        "authorized_official_telephone_number": "303-669-3771",
        "authorized_official_credential": "BOCPD"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Denver, CO
• Providers in Denver, CO by specialty
• Customized Equipment (DME) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; 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.