NPIMap

Organization Active NPI

Southlake Orthopaedics Sports Medicine and Spine Center, PC

Doing business as Southlake Prosthetics and Orthotics

  • Prosthetic/Orthotic Supplier
  • Hoover, AL
National Provider Identifier
1780281741
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
SOUTHLAKE ORTHOPAEDICS SPORTS MEDICINE AND SPINE CENTER, PC
Doing business as
Southlake Prosthetics and Orthotics
Practice address
4524 Southlake Pkwy Ste 26
Hoover, AL 35244-3272
Phone
(205) 985-4111
Fax
(888) 435-9974
NPI assigned
Oct 2, 2020
Last updated
Feb 10, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHLAKE ORTHOPAEDICS SPORTS MEDICINE AND SPINE CENTER, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Authorized official

Name
Mr. Robert Crabtree
Title
Administrator
Phone
(205) 985-4111

Specialties & licenses 2

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

Addresses

Primary practice location

4524 Southlake Pkwy Ste 26
Hoover, AL 35244-3272

Mailing address

4517 Southlake Pkwy
Hoover, AL 35244-3280
Phone (205) 985-4111

Other names 1

  • Southlake Prosthetics and Orthotics Doing business as

National Provider Directory

National Provider Directory
Part of
Southlake Ortho Sports PC

Locations

3686 Grandview Pkwy
Ste 430
Birmingham, AL 35243
Phone (205) 605-8180

4517 Southlake Pkwy
Ste 202
Hoover, AL 35244
Phone (205) 985-4111

7191 Cahaba Valley Rd
Ste 206
Hoover, AL 35242
Phone (205) 408-6421

Practitioners & affiliated clinicians

Practitioners 43

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.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1780281741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4517 SOUTHLAKE PKWY",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352443280",
            "telephone_number": "205-985-4111",
            "fax_number": "205-985-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4524 SOUTHLAKE PKWY STE 26",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352443272",
            "telephone_number": "205-985-4111",
            "fax_number": "888-435-9974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAKE ORTHOPAEDICS SPORTS MEDICINE AND SPINE CENTER, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHLAKE ORTHOPAEDICS SPORTS MEDICINE AND SPINE CENTER, PC",
        "enumeration_date": "2020-10-02",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "CRABTREE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "205-985-4111",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southlake Prosthetics and Orthotics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southlake Prosthetics and Orthotics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hoover, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.