NPIMap

Organization Active NPI

Teter Orthotics & Prosthetics, Inc

  • Prosthetic/Orthotic Supplier
  • Traverse City, MI
National Provider Identifier
1801891973
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
TETER ORTHOTICS & PROSTHETICS, INC
Practice address
1225 W Front St Ste a
Traverse City, MI 49684-2368
Phone
(231) 947-5701
Fax
(231) 947-1370
NPI assigned
Jun 16, 2005
Organization subpart
Yes
Parent organization
TETER ORTHOTICS & PROSTHETICS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Grace Angeline
Title
Reg Compliance Specialist III
Phone
(714) 961-2102

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Prosthetic/Orthotic Supplier 335E00000X MI Primary

Addresses

Primary practice location

1225 W Front St Ste a
Traverse City, MI 49684-2368

Mailing address

PO Box 650846
Dallas, TX 75265-0846

Other identifiers 1

IdentifierTypeStateIssuer
2002499MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930076794 MI DME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 7416075049 Practice locations: Traverse City, MI

Other NPIs with the same Medicare PAC ID 12

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
Teter Orthotics and Prosthetics Inc1225 W Front St, Traverse City, MI 49684-2368(231) 947-5701 Neuromuscular Elect Stimulators (NMES)/Supplies|Canes and/or Crutches|Walkers|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|Lymphedem… Does not accept assignmentParticipating since Jan 1, 2023

National Provider Directory

National Provider Directory
Tax ID family
Teter Orthotics and15 organizations share this tax ID, including this one
Part of
Teter Orthotics and

Other organizations with this tax ID 14

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

View all 14

Member of 1

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

Locations

8865 Professional Dr
Cadillac, MI 49601
Phone (231) 775-6321

515 Michigan St NE
Ste 301
Grand Rapids, MI 49503
Phone (616) 456-8115

1400 E Parkdale Ave
Ste 1
Manistee, MI 49660
Phone (231) 398-1780

1415 Kilborn Dr
Petoskey, MI 49770
Phone (231) 347-5510

2500 Niles Rd
Ste 11
Saint Joseph, MI 49085
Phone (269) 408-4800

501 Court St
Sault South Marie, MI 49783
Phone (906) 327-3310

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1801891973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650846",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 W FRONT ST STE A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842368",
            "telephone_number": "231-947-5701",
            "fax_number": "231-947-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TETER ORTHOTICS & PROSTHETICS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TETER ORTHOTICS & PROSTHETICS, INC",
        "enumeration_date": "2005-06-16",
        "last_updated": "2022-07-21",
        "certification_date": "2021-10-11",
        "status": "A",
        "authorized_official_last_name": "ANGELINE",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "REG COMPLIANCE SPECIALIST III",
        "authorized_official_telephone_number": "714-961-2102"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2002499",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.