Orthotics & Prosthetics East Inc

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

ORTHOTICS & PROSTHETICS EAST INC

Practice address

1025 WH Smith Blvd
Suite 108
Greenville, NC 27834-5052

Phone

(252) 215-2215

Fax

(252) 215-2216

NPI assigned

May 16, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Richard Shane Coltrain, CPONPI 1417994500

Title

President

Phone

(252) 215-2215

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

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

Locations

Practitioners 9

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

• Richard Shane Coltrain, CPO

  • Prosthetist
  • Greenville, NC
  • NPI 1417994500

  Orthotist

  NPD (past) Authorized official
• James Martin Bonnett, CPED

  • Orthotist
  • Greenville, NC
  • NPI 1194399881
  NPD (past)
• Randy L Daniel, CPO

  • Prosthetist
  • Greenville, NC
  • NPI 1306163860

  Orthotist

  NPD (past)
• Travis L Dessoffy, CPO

  • Prosthetist
  • Greenville, NC
  • NPI 1376663534

  Orthotist

  NPD (past)
• Timothy Bruce Foster, CO

  • Orthotist
  • Greenville, NC
  • NPI 1689798522
  NPD (past)
• Michael Looker II

  • Prosthetist
  • Greenville, NC
  • NPI 1548193527

  Orthotist

  NPD (past)
• Garry Ogilvie, CO, FAAOP

  • Orthotist
  • Greenville, NC
  • NPI 1912396052
  NPD (past)
• Braden D Teller, CP

  • Prosthetist
  • Greenville, NC
  • NPI 1528572005
  NPD (past)
• Penny C Tripp, CPED

  • Pedorthist
  • Greenville, NC
  • NPI 1033451042
  NPD (past)

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628035200000",
    "number": "1790736379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 WH SMITH BLVD",
            "address_2": "SUITE 108",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345052",
            "telephone_number": "252-215-2215",
            "fax_number": "252-215-2216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 WH SMITH BLVD",
            "address_2": "SUITE 108",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345052",
            "telephone_number": "252-215-2215",
            "fax_number": "252-215-2216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOTICS & PROSTHETICS EAST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A",
        "authorized_official_last_name": "COLTRAIN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-215-2215",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7704508",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC #",
            "identifier": "0464J",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karina Orozco
• Haley Elizabeth Orr, BCBA
• Orlando Orrego
• Laura Melissa Ortega Aviles, MD
• Orthopaedics East & Sports Medicine Center, Inc.
• Briceida Guadalupe Osborne, RD
• Allen L. Oseroff, M.D.
• Ann Ostrovsky, M.D.
• Kehinde Kemi Osunsan, D.D.S.
• Samantha Sara Oswald, PMHNP

• Customized Equipment (DME) in Greenville, NC
• Providers in Greenville, NC by specialty
• Customized Equipment (DME) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; 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.