Hackley Orthotics & Prosthetics

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

HACKLEY ORTHOTICS & PROSTHETICS

Practice address

1887 E Sherman Blvd
Muskegon, MI 49444-1859

Phone

(231) 739-2217

Fax

(231) 737-6119

NPI assigned

Sep 7, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Gerald Michael Lunsford, CO

Title

Director

Phone

(231) 739-2217

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lakeshore Orthotics & Prosthetics Former legal business name

Locations

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679567549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1887 E SHERMAN BLVD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441859",
            "telephone_number": "231-739-2217",
            "fax_number": "231-737-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1887 E SHERMAN BLVD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441859",
            "telephone_number": "231-739-2217",
            "fax_number": "231-737-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HACKLEY ORTHOTICS & PROSTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUNSFORD",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "231-739-2217",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "530F10776",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeshore Orthotics & Prosthetics",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Prosthetic/Orthotic Supplier in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Prosthetic/Orthotic Supplier in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.