NPIMap

Organization Active NPI

Mary Free Bed Orthotics and Prosthetics

  • Prosthetic/Orthotic Supplier
  • South Bend, IN
National Provider Identifier
1780426361
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
MARY FREE BED ORTHOTICS AND PROSTHETICS
Practice address
100 Navarre PL Ste 5595B
South Bend, IN 46601-1156
Phone
(616) 840-8007
NPI assigned
Jun 12, 2024
Last updated
Jun 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Authorized official

Name
Robert Tuck, CPO
Title
Compliance Director
Phone
(616) 502-6488

Specialties & licenses 1

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

Addresses

Primary practice location

100 Navarre PL Ste 5595B
South Bend, IN 46601-1156

Mailing address

235 Wealthy St SE Ste 1100
Grand Rapids, MI 49503-5247
Phone (616) 617-0538

Other names 1

  • Mary Free Bed Brace and Corset Shop Other name

National Provider Directory

National Provider Directory
Tax ID family
Mary Free Bed Orthotics and Prosthetics13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

100 Navarre Pl
Ste 5595B
South Bend, IN 46601
Phone (616) 840-8007

NPI Registry JSON

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1780426361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 WEALTHY ST SE STE 1100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035247",
            "telephone_number": "616-617-0538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NAVARRE PL STE 5595B",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011156",
            "telephone_number": "616-840-8007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY FREE BED ORTHOTICS AND PROSTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-12",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "TUCK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "COMPLIANCE DIRECTOR",
        "authorized_official_telephone_number": "616-502-6488",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mary Free Bed Brace and Corset Shop",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.