Orthostance Medical LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ORTHOSTANCE MEDICAL LLC

Practice address

1401 Dyal School Rd
Baxley, GA 31513-3701

Phone

(912) 246-5497

NPI assigned

Aug 17, 2018

Last updated

Aug 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Brad Disharoon

Title

Owner

Phone

(912) 246-5497

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1831679992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 DYAL SCHOOL RD",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315133701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 DYAL SCHOOL RD",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315133701",
            "telephone_number": "912-246-5497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOSTANCE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-17",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "DISHAROON",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-246-5497",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Baxley, GA
• Providers in Baxley, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.