NPIMap

Organization Active NPI

Country Cobbler, LTD.

  • Prosthetic/Orthotic Supplier
  • Smithfield, NC
National Provider Identifier
1821344706
Registry record updated May 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
00992 Issued in NC
Legal business name
COUNTRY COBBLER, LTD.
Practice address
255 N Equity Dr Ste a
Smithfield, NC 27577-6054
Phone
(919) 989-6190
Fax
(919) 989-6127
NPI assigned
Jul 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2014

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

Authorized official

Name
Mr. Monty K. Mantey
Title
President/Owner
Phone
(910) 772-9994

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 00992 NC Primary

Addresses

Primary practice location

255 N Equity Dr Ste a
Smithfield, NC 27577-6054

Mailing address

255 N Equity Dr Ste a
Smithfield, NC 27577-6054
Phone (919) 989-6190

National Provider Directory

National Provider Directory

Locations

255 N Equity Dr
Ste A
Smithfield, NC 27577
Phone (919) 989-6190

NPI Registry JSON

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401148800000",
    "number": "1821344706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 N EQUITY DR STE A",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275776054",
            "telephone_number": "919-989-6190",
            "fax_number": "919-989-6127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N EQUITY DR STE A",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275776054",
            "telephone_number": "919-989-6190",
            "fax_number": "919-989-6127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY COBBLER, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-30",
        "last_updated": "2014-05-27",
        "status": "A",
        "authorized_official_last_name": "MANTEY",
        "authorized_official_first_name": "MONTY",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "910-772-9994",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NC",
            "license": "00992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithfield, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2014; 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.