Tampa Bay Orthopaedic Designs Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

POR124 Issued in FL

Legal business name

TAMPA BAY ORTHOPAEDIC DESIGNS INC

Practice address

812 W Martin Luther King Blvd
Ste 100
Tampa, FL 33603-3338

Phone

(813) 224-0525

Fax

(813) 224-0622

NPI assigned

Aug 31, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Olaf Mickle Holm Sr., LPO, CO, BOCPONPI 1740797901

Title

Owner/President

Phone

(813) 224-0525

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Tampa Bay Orthopaedic Designs, Inc.

  • Prosthetic/Orthotic Supplier
  • Brandon, FL
  • NPI 1861685083
  NPPES parent name

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Olaf M Holm, LPO

  • Prosthetist
  • Tampa, FL
  • NPI 1740797901

  Orthotist

  NPD (past) Authorized official
• Amy Holm

  • Prosthetic/Orthotic Supplier
  • Tampa, FL
  • NPI 1922429588
  NPD
• Hector L Beza, OF

  • Orthotic Fitter
  • Tampa, FL
  • NPI 1841824869
  NPD (past)

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576627200000",
    "number": "1629061007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 W MARTIN LUTHER KING BLVD",
            "address_2": "STE 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336033338",
            "telephone_number": "813-224-0525",
            "fax_number": "813-224-0622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 W MARTIN LUTHER KING BLVD",
            "address_2": "STE 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336033338",
            "telephone_number": "813-224-0525",
            "fax_number": "813-224-0622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMPA BAY ORTHOPAEDIC DESIGNS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-31",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A",
        "authorized_official_last_name": "HOLM",
        "authorized_official_first_name": "OLAF",
        "authorized_official_middle_name": "MICKLE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "813-224-0525",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "LPO, CO, BOCPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "FL",
            "license": "POR124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005843900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Tampa, FL
• Providers in Tampa, FL by specialty
• Prosthetic/Orthotic Supplier in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.