NPIMap

Organization Active NPI

Durrett'S Orthotic and Prosthetic LLC

  • Prosthetic/Orthotic Supplier
  • Lawrenceburg, IN
National Provider Identifier
1780303883
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
DURRETT'S ORTHOTIC AND PROSTHETIC LLC
Practice address
1049 W Eads Pkwy
Lawrenceburg, IN 47025-1162
Phone
(812) 489-7304
Fax
(812) 489-7320
NPI assigned
Aug 23, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Authorized official

Name
Mrs. Suzanne Ward
Title
Owner
Phone
(859) 341-7688

Specialties & licenses 1

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

Addresses

Primary practice location

1049 W Eads Pkwy
Lawrenceburg, IN 47025-1162

Mailing address

20 Medical Village Dr Ste 100
Edgewood, KY 41017-5403
Phone (859) 341-7688

Other identifiers 1

IdentifierTypeStateIssuer
300064747MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230112001682 IN DME Supplier - Certified Orth/Pros/Pedorthist 5698894954 Practice locations: Lawrenceburg, IN

Other NPIs with the same Medicare PAC ID 1

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
Durrett'S Orthotics and Prosthetics1049 W Eads Pkwy, Lawrenceburg, IN 47025-1162(812) 489-7304 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
Durrett'S Orthotic and Prosthetic LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1049 W Eads Pkwy
Lawrenceburg, IN 47025
Phone (812) 489-7304

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670198400000",
    "number": "1780303883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MEDICAL VILLAGE DR STE 100",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410175403",
            "telephone_number": "859-341-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 W EADS PKWY",
            "city": "LAWRENCEBURG",
            "state": "IN",
            "postal_code": "470251162",
            "telephone_number": "812-489-7304",
            "fax_number": "812-489-7320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DURRETT'S ORTHOTIC AND PROSTHETIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-341-7688",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300064747",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceburg, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.