NPIMap

Organization Active NPI

Graybeal Orthopedic LLC

Doing business as Anchor Brace and Limb

  • Prosthetic/Orthotic Supplier
  • Kingsport, TN
National Provider Identifier
1740951714
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
GRAYBEAL ORTHOPEDIC LLC
Doing business as
Anchor Brace and Limb
Practice address
430 W Ravine Rd Ste 100B
Kingsport, TN 37660-3868
Phone
(423) 863-4191
Fax
(844) 419-1119
NPI assigned
Sep 21, 2021
Last updated
Mar 17, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
GRAYBEAL ORTHOPEDIC LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Authorized official

Name
Adam Lee Fann, CPO
Title
Owner
Phone
(423) 975-9884

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Customized Equipment (DME) 332BC3200X
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

430 W Ravine Rd Ste 100B
Kingsport, TN 37660-3868

Mailing address

107 E Myrtle Ave
Johnson City, TN 37601-4631
Phone (423) 975-9884

Other names 1

  • Anchor Brace and Limb Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211118000771 TN DME Supplier - Prosthetic PersonnelDME Supplier - Orthotic Personnel 2163542234 Practice locations: Kingsport, TN

Other NPIs with the same Medicare PAC ID 4

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
Graybeal Orthopedic LLC430 W Ravine Rd, Kingsport, TN 37660-3868(423) 863-4191 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Breast Prostheses and/or Accessories|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Graybeal Orthopedic LLC5 organizations share this tax ID, including this one
Part of
Graybeal Orthopedic LLC

Other organizations with this tax ID 4

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

Locations

1309 S John B Dennis Hwy
Ste 104
Kingsport, TN 37660
Phone (423) 765-1393

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742169600000",
    "number": "1740951714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 E MYRTLE AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376014631",
            "telephone_number": "423-975-9884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 W RAVINE RD STE 100B",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603868",
            "telephone_number": "423-863-4191",
            "fax_number": "844-419-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAYBEAL ORTHOPEDIC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRAYBEAL ORTHOPEDIC LLC",
        "enumeration_date": "2021-09-21",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A",
        "authorized_official_last_name": "FANN",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-975-9884",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anchor Brace and Limb",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Anchor Brace and Limb",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kingsport, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; 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.