Dynamics Orthotics and Prosthetics LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

2007#120651 Issued in GA

Legal business name

DYNAMICS ORTHOTICS AND PROSTHETICS LLC

Practice address

5701 Mableton Pkwy SW Ste 102
Mableton, GA 30126-3395

Phone

(678) 398-8710

Fax

(678) 398-8711

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Mr. M Maxwell Fitzgerald

Title

Ceo

Phone

(770) 953-4877

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281916800000",
    "number": "1790801041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4599 SOMERSET RD SW",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300824538",
            "telephone_number": "770-953-4877",
            "fax_number": "770-988-8958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 MABLETON PKWY SW STE 102",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301263395",
            "telephone_number": "678-398-8710",
            "fax_number": "678-398-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMICS ORTHOTICS AND PROSTHETICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2010-08-16",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "M",
        "authorized_official_middle_name": "MAXWELL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-953-4877",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "2007#120651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; 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.