NPIMap

Organization Active NPI

Prevail Prosthetics and Orthotics

  • Prosthetic/Orthotic Supplier
  • Indianapolis, IN
National Provider Identifier
1639498587
Registry record updated Sep 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
PREVAIL PROSTHETICS AND ORTHOTICS
Practice address
6330 E 75TH St
Suite 126
Indianapolis, IN 46250-2777
Phone
(317) 577-2273
Fax
(317) 577-2279
NPI assigned
May 18, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2015

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

Authorized official

Name
Christi Hudson
Title
Business Manager
Phone
(260) 483-5219

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

6330 E 75TH St
Suite 126
Indianapolis, IN 46250-2777

Mailing address

7735 W Jefferson Blvd
Suite C
Fort Wayne, IN 46804-4135
Phone (260) 483-5219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930097413 IN DME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 6709903263 Practice locations: Indianapolis, IN

Other NPIs with the same Medicare PAC ID 5

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

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Prevail Prosthetics and Orthotics6330 E 75TH St, Indianapolis, IN 46250-2717(317) 577-2273 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items Accepts assignmentParticipating since Jan 1, 2021

National Provider Directory

National Provider Directory
Tax ID family
Prevail Prosthetics Orthotics8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1274140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441238400000",
    "number": "1639498587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7735 W JEFFERSON BLVD",
            "address_2": "SUITE C",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044135",
            "telephone_number": "260-483-5219",
            "fax_number": "260-484-2291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 E 75TH ST",
            "address_2": "SUITE 126",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502777",
            "telephone_number": "317-577-2273",
            "fax_number": "317-577-2279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVAIL PROSTHETICS AND ORTHOTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-18",
        "last_updated": "2015-09-03",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "CHRISTI",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "260-483-5219"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; 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.