NPIMap

Organization Active NPI

Prevail Prosthetics and Orthotics

  • Prosthetic/Orthotic Supplier
  • Anderson, IN
National Provider Identifier
1881865368
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
PREVAIL PROSTHETICS AND ORTHOTICS
Practice address
3320 Main St
Suite F
Anderson, IN 46013-4265
Phone
(765) 374-0496
Fax
(765) 288-3884
NPI assigned
Mar 12, 2008
Last updated
Jan 4, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2019

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

Authorized official

Name
Christi Hudson
Title
Business Manager
Phone
(260) 483-5219

Specialties & licenses 1

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

Addresses

Primary practice location

3320 Main St
Suite F
Anderson, IN 46013-4265

Mailing address

7735 W Jefferson Blvd
Suite C
Fort Wayne, IN 46804-4135
Phone (260) 483-5219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930032697 IN DME Supplier - Orthotic PersonnelDME Supplier - Prosthetic PersonnelDME Supplier - Other 6709903263 Practice locations: Anderson, IN

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Prevail Prosthetics and Orthotics3320 Main St, Anderson, IN 46013-4267(765) 374-0496 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items Accepts assignmentParticipating since Jan 1, 2021

National Provider Directory

National Provider Directory
Tax ID family
Prevail Prosthetics and Orthotics Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546560000000",
    "number": "1881865368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7735 W JEFFERSON BLVD",
            "address_2": "SUITE C",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044135",
            "telephone_number": "260-483-5219",
            "fax_number": "260-484-2291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 MAIN ST",
            "address_2": "SUITE F",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460134265",
            "telephone_number": "765-374-0496",
            "fax_number": "765-288-3884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVAIL PROSTHETICS AND ORTHOTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-12",
        "last_updated": "2019-01-04",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "CHRISTI",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "260-483-5219"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.