Prosthetic Orthotic Specialists, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

PROSTHETIC ORTHOTIC SPECIALISTS, INC.

Practice address

5095 Ellison St NE
Albuquerque, NM 87109-4326

Phone

(505) 244-0404

Fax

(505) 244-0708

NPI assigned

Dec 4, 2015

Organization subpart

Yes

Parent organization

ELITE PROSTHETICSAs reported in NPPES

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

Authorized official

Name

Ms. Kristen M Nelson

Title

Coo

Phone

(505) 244-0404

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Center for Prosthetic & Orthotic Design Doing business as

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Elite Prosthetics

  • Prosthetic/Orthotic Supplier
  • Albuquerque, NM
  • NPI 1740739218
  NPPES parent name

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

{
    "created_epoch": "1449187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471392000000",
    "number": "1851766752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91630",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871991630",
            "telephone_number": "505-244-0404",
            "fax_number": "505-244-0708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5095 ELLISON ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094326",
            "telephone_number": "505-244-0404",
            "fax_number": "505-244-0708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSTHETIC ORTHOTIC SPECIALISTS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELITE PROSTHETICS",
        "enumeration_date": "2015-12-04",
        "last_updated": "2016-08-17",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "505-244-0404",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NM",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000T6178",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Prosthetic & Orthotic Design",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gerald Frank Prohaska, DDS,MS
• Erica Prokopich, NP-C
• Prospera Healthcare New Mexico LLC
• Tony Jacinto Prosser, PHARMD
• Prosthetic Orthotic Specialists, Inc
• Shawn Proudfoot, LISW
• Joan Prouty, PA-C
• Desiree Renee Provencio, DNP, CNP, PMHNP-BC
• Providence Support Services Inc.
• Provider Cares Network LLC

• Prosthetic/Orthotic Supplier in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Prosthetic/Orthotic Supplier in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; 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.