NPIMap

Organization Active NPI

Innovative Prosthetic Care, LLC

  • Prosthetic/Orthotic Supplier
  • Mobile, AL
National Provider Identifier
1679852586
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
535 Issued in AL
Legal business name
INNOVATIVE PROSTHETIC CARE, LLC
Practice address
1109 Wi-65 Service Rd N
Mobile, AL 36618
Phone
(251) 470-0901
Fax
(251) 650-1671
NPI assigned
Aug 9, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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

Authorized official

Name
Mrs. Leslie A Patton
Title
Owner/Manager
Phone
(251) 470-0901

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 535 AL Primary

Addresses

Primary practice location

1109 Wi-65 Service Rd N
Mobile, AL 36618

Mailing address

9034B Carl Legett Rd
Gulfport, MS 39503-6234
Phone (228) 604-0818

National Provider Directory

National Provider Directory

Locations

1109 W I65 Service Rd N
Mobile, AL 36618
Phone (251) 470-0901

9034B Carl Legett Rd
Gulfport, MS 39503

NPI Registry JSON

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318464000000",
    "number": "1679852586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9034B CARL LEGETT RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395036234",
            "telephone_number": "228-604-0818",
            "fax_number": "228-604-0815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 WI-65 SERVICE RD N",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "36618",
            "telephone_number": "251-470-0901",
            "fax_number": "251-650-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE PROSTHETIC CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-09",
        "last_updated": "2011-10-13",
        "status": "A",
        "authorized_official_last_name": "PATTON",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "251-470-0901",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "AL",
            "license": "535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; 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.