Organization Active NPI

Liston Prosthetics, LLC

  • Prosthetic/Orthotic Supplier
  • Murray, UT
National Provider Identifier
1669935292
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
LISTON PROSTHETICS, LLC
Practice address
5292 S College Dr Ste 103
Murray, UT 84123-2959
Phone
(385) 425-3960
Fax
(385) 425-3965
NPI assigned
Apr 10, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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

Authorized official

Name
Mr. James William Liston, CPNPI 1104396217
Title
Certified Prosthetist
Phone
(385) 425-3960

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

5292 S College Dr Ste 103
Murray, UT 84123-2959

Mailing address

5292 S College Dr Ste 103
Murray, UT 84123-2959
Phone (385) 425-3960

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190903001146 UT DME Supplier - Prosthetic Personnel 4183953037 Practice locations: Murray, UT

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
Liston Prosthetics5292 S College Dr, Murray, UT 84123-2959(385) 425-3960 Limb Prostheses Does not accept assignmentParticipating since May 2, 2019

National Provider Directory

National Provider Directory

Locations

5292 S College Dr
Ste 103
Salt Lake City, UT 84123
Phone (385) 425-3960

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554854400000",
    "number": "1669935292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5292 S COLLEGE DR STE 103",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841232959",
            "telephone_number": "385-425-3960",
            "fax_number": "385-425-3965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5292 S COLLEGE DR STE 103",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841232959",
            "telephone_number": "385-425-3960",
            "fax_number": "385-425-3965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISTON PROSTHETICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-10",
        "last_updated": "2019-04-10",
        "status": "A",
        "authorized_official_last_name": "LISTON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CERTIFIED PROSTHETIST",
        "authorized_official_telephone_number": "385-425-3960",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CP"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; 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.