Active NPI
Northern Brace Company Inc
- Prosthetic/Orthotic Supplier
- Mishawaka, IN
National Provider Identifier
1881884971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- Legal business name
- NORTHERN BRACE COMPANY INC
- Practice address
- 60160 Bodnar Blvd Ste. 200
Mishawaka, IN 46544 - Phone
- (574) 256-9008
- Fax
- (574) 256-9016
- NPI assigned
- Jul 26, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Kelly L West
- Title
- Vice President
- Phone
- (574) 233-4221
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Prosthetic/Orthotic Supplier | 335E00000X | Primary |
Addresses
Primary practice location
60160 Bodnar Blvd Ste. 200
Mishawaka, IN 46544
Mailing address
610 N Michigan St Ste 104
South Bend, IN 46601-1078
Phone (574) 233-4221
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100153030C | Medicaid | IN |
Other names 1
- Northern Brace Northern Prosthetics
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- Livonia, MI
- NPI 1427325653
Member Of
Locations
60160 Bodnar Blvd
Ste 200
Mishawaka, IN 46544
Phone (574) 256-9008
610 N Michigan St
Ste 104
South Bend, IN 46601
Phone (574) 233-4221
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185408000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1354838400000",
"number": "1881884971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 N MICHIGAN ST STE 104",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466011078",
"telephone_number": "574-233-4221",
"fax_number": "574-233-3966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60160 BODNAR BLVD STE. 200",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "46544",
"telephone_number": "574-256-9008",
"fax_number": "574-256-9016"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHERN BRACE COMPANY INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-07-26",
"last_updated": "2012-12-07",
"status": "A",
"authorized_official_last_name": "WEST",
"authorized_official_first_name": "KELLY",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "574-233-4221",
"authorized_official_name_prefix": "Mrs."
},
"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": "100153030C",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Northern Brace Northern Prosthetics",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Mishawaka, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.