Creative Orthotic & Prosthetic Services

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CREATIVE ORTHOTIC & PROSTHETIC SERVICES

Practice address

120 E Redstone Ave
# C
Crestview, FL 32539-5370

Phone

(850) 398-8159

NPI assigned

Nov 14, 2007

Organization subpart

No

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

Authorized official

Name

Charles Sedillo Mata, C.O.NPI 1245438704

Title

President

Phone

(850) 398-8159

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Charles Sedillo Mata, CO

  • Specialist
  • Crestview, FL
  • NPI 1245438704
  NPD Authorized official

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338422400000",
    "number": "1770763179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E REDSTONE AVE",
            "address_2": "# C",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325395370",
            "telephone_number": "850-398-8159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E REDSTONE AVE",
            "address_2": "# C",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325395370",
            "telephone_number": "850-398-8159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE ORTHOTIC & PROSTHETIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2012-05-31",
        "status": "A",
        "authorized_official_last_name": "MATA",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "SEDILLO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-398-8159",
        "authorized_official_credential": "C.O."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Wayne Cox
• Heather Cox, RBT
• Michael Coyne
• Andrea Craig, APRN
• Bridget Cramer
• Traci Ann Cremer, ISW
• Crestview Chiropractic Clinic, Inc
• Crestview City Pharmacy Inc (Crestview City Pharmacy)
• Crestview Dental Care PLLC
• Crestview HCC LLC

• Durable Medical Equipment & Medical Supplies in Crestview, FL
• Providers in Crestview, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2012; 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.