Glacier Prosthetic Care, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

385 Issued in WA

Legal business name

GLACIER PROSTHETIC CARE, INC.

Practice address

205 Vermeer Dr
Suite C
Ponderay, ID 83852-1660

Phone

(208) 255-4106

Fax

(208) 255-4102

NPI assigned

Mar 5, 2007

Last updated

Nov 18, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Gina Carpenter

Title

Vice President

Phone

(406) 755-3344

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeanne Marie Arnold, DPM

  • Podiatrist
  • Sandpoint, ID
  • NPI 1265485882
  NPD (past)

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258502400000",
    "number": "1750410825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985 N MERIDIAN RD",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013539",
            "telephone_number": "406-755-3344",
            "fax_number": "406-755-2746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 VERMEER DR",
            "address_2": "SUITE C",
            "city": "PONDERAY",
            "state": "ID",
            "postal_code": "838521660",
            "telephone_number": "208-255-4106",
            "fax_number": "208-255-4102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLACIER PROSTHETIC CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2009-11-18",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "406-755-3344",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "WA",
            "license": "385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807555300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan Donald Fisher, DPM
• Samantha Ann Fisher, RD, LD
• Thomas G Fletcher, M.D.
• Foster Holdings LTD (Well Life Sand Creek Pharmacy)
• Kathy Gavin, FNP
• Rebecca Goebel, LMT
• Sadie Green
• Michaella A. Hammersberg, LCSW
• Susan Hansen, M.ED.
• Debra Mae Haworth-Bush, CADC,CPRC,CPSS,CFSP

• Prosthetic/Orthotic Supplier in Ponderay, ID
• Providers in Ponderay, ID by specialty
• Prosthetic/Orthotic Supplier in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; 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.