Organization Active NPI

Creative Orthotics & Prosthetics, Inc.

  • Prosthetic/Orthotic Supplier
  • Ithaca, NY
National Provider Identifier
1871683003
Registry record updated Oct 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
CREATIVE ORTHOTICS & PROSTHETICS, INC.
Practice address
310 Taughannock Blvd
Suite 1a
Ithaca, NY 14850-3231
Phone
(607) 277-6620
Fax
(607) 277-2533
NPI assigned
Oct 16, 2006
Last updated
Oct 14, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
HANGER ORTHOPEDIC GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 14, 2009

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

Authorized official

Name
Sheryl S Price
Title
Director of Reimbursement
Phone
(503) 493-8288

Specialties & licenses 2

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

Addresses

Primary practice location

310 Taughannock Blvd
Suite 1a
Ithaca, NY 14850-3231

Mailing address

310 Taughannock Blvd
Suite 1a
Ithaca, NY 14850-3231
Phone (607) 277-6620

Other identifiers 1

IdentifierTypeStateIssuer
02179239MedicaidNY

National Provider Directory

National Provider Directory

Locations

310 Taughannock Blvd
Ste 1A
Ithaca, NY 14850
Phone (607) 277-6620

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255478400000",
    "number": "1871683003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 TAUGHANNOCK BLVD",
            "address_2": "SUITE 1A",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148503231",
            "telephone_number": "607-277-6620",
            "fax_number": "607-277-2533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 TAUGHANNOCK BLVD",
            "address_2": "SUITE 1A",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148503231",
            "telephone_number": "607-277-6620",
            "fax_number": "607-277-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE ORTHOTICS & PROSTHETICS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HANGER ORTHOPEDIC GROUP",
        "enumeration_date": "2006-10-16",
        "last_updated": "2009-10-14",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "SHERYL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "503-493-8288"
    },
    "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02179239",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2009; 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.