Active NPI
Prevail Prosthetics and Orthotics
- Prosthetic/Orthotic Supplier
- Fort Wayne, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- Legal business name
- PREVAIL PROSTHETICS AND ORTHOTICS
- Practice address
- 10826 Coldwater Rd.
Fort Wayne, IN 46845-1241 - Phone
- (260) 483-5219
- Fax
- (260) 484-2291
- NPI assigned
- Mar 12, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Christi S Hudson
- Title
- Business Manager
- Phone
- (260) 483-5219
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | Primary |
Addresses
Primary practice location
10826 Coldwater Rd.
Fort Wayne, IN 46845-1241
Mailing address
7735 W. Jefferson Blvd. Ste. C
Fort Wayne, IN 46804-4135
Phone (260) 483-5219
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930031639 | IN | DME Supplier - Prosthetic Personnel | 6709903263 | Practice locations: Fort Wayne, IN |
Other NPIs with the same Medicare PAC ID 5
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Prosthetic/Orthotic Supplier
- Indianapolis, IN
- NPI 1639498587
6709903263
-
- Prosthetic/Orthotic Supplier
- Anderson, IN
- NPI 1881865368
6709903263
-
- Prosthetic/Orthotic Supplier
- Greenfield, IN
- NPI 1245004795
6709903263
-
- Prosthetic/Orthotic Supplier
- Fort Wayne, IN
- NPI 1366583759
6709903263
Laboratory certificates & supplier records
Derived by NPIMapThese 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
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Prevail Prosthetics and Orthotics | Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Lymphedema Compression Treatment Items | Accepts assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Prevail Prosthetics Orthotics
Other organizations with this tax ID 7
Organizations that report the same tax identification number in the National Provider Directory.
-
- Prosthetic/Orthotic Supplier
- Fort Wayne, IN
- NPI 1588653497
-
- Prosthetic/Orthotic Supplier
- Muncie, IN
- NPI 1255502720
-
- Prosthetic/Orthotic Supplier
- Indianapolis, IN
- NPI 1639498587
-
- Prosthetic/Orthotic Supplier
- Anderson, IN
- NPI 1881865368
-
- Prosthetic/Orthotic Supplier
- Greenfield, IN
- NPI 1245004795
-
- Prosthetic/Orthotic Supplier
- Fort Wayne, IN
- NPI 1366583759
-
- Prosthetic/Orthotic Supplier
- Warsaw, IN
- NPI 1396916888
Locations
10826 Coldwater Rd
Fort Wayne, IN 46845
Phone (260) 483-5219
3906 New Vision Dr
Fort Wayne, IN 46845
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205280000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1575849600000",
"number": "1780855239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7735 W. JEFFERSON BLVD. STE. C",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468044135",
"telephone_number": "260-483-5219",
"fax_number": "260-203-2155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10826 COLDWATER RD.",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451241",
"telephone_number": "260-483-5219",
"fax_number": "260-484-2291"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PREVAIL PROSTHETICS AND ORTHOTICS",
"organizational_subpart": "NO",
"enumeration_date": "2008-03-12",
"last_updated": "2019-12-09",
"certification_date": "2019-12-09",
"status": "A",
"authorized_official_last_name": "HUDSON",
"authorized_official_first_name": "CHRISTI",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "BUSINESS MANAGER",
"authorized_official_telephone_number": "260-483-5219"
},
"taxonomies": [
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; 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.