Mobile Prosthetics of Kentucky

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

MOBILE PROSTHETICS OF KENTUCKY

Practice address

610 W Main St
Ste E
Campbellsville, KY 42718-2501

Phone

(270) 465-8522

Fax

(270) 465-8523

NPI assigned

Nov 22, 2011

Organization subpart

No

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

Authorized official

Name

Tony Garrett Cook, LCPNPI 1902133788

Title

President

Phone

(270) 465-8522

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• Tony Garrett Cook, LCP

  • Prosthetic/Orthotic Supplier
  • Campbellsville, KY
  • NPI 1902133788
  NPD (past) Authorized official

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

{
    "created_epoch": "1321920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354492800000",
    "number": "1811264674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 W MAIN ST",
            "address_2": "STE E",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427182501",
            "telephone_number": "270-465-8522",
            "fax_number": "270-465-8523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 W MAIN ST",
            "address_2": "STE E",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427182501",
            "telephone_number": "270-465-8522",
            "fax_number": "270-465-8523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE PROSTHETICS OF KENTUCKY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-22",
        "last_updated": "2012-12-03",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "GARRETT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "270-465-8522",
        "authorized_official_credential": "LCP"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100209830",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATHEM BLUE CROSS AND BLUE SHIELD",
            "identifier": "000000788517",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haley Samantha Middleton
• Alison Elizabeth Milby
• Meleigha Milby, PHARMD
• Leann Miller, CADC
• Karen Mills, SLP
• Modern Care LLC
• Modern Care LLC
• Brad Montgomery
• David A Montgomery, MD
• Casey Lane Morris, PHARMACY INTERN

• Prosthetic/Orthotic Supplier in Campbellsville, KY
• Providers in Campbellsville, KY by specialty
• Prosthetic/Orthotic Supplier in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; 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.