NPIMap

Organization Active NPI

Albemarle Orthotics & Prosthetics, Inc

  • Customized Equipment (DME)
  • Greenville, NC
National Provider Identifier
1912437930
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
ALBEMARLE ORTHOTICS & PROSTHETICS, INC
Practice address
1970 W Arlington Blvd Ste a
Greenville, NC 27834-5783
Phone
(252) 378-9770
Fax
(252) 378-9880
NPI assigned
Jun 13, 2017
Last updated
Dec 9, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
ALBEMARLE ORTHOTICS & PROSTHETICS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Authorized official

Name
Kimberly S Williamson, CPONPI 1699788372
Title
Owner
Phone
(252) 338-3002

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetist 224P00000X NU
Customized Equipment (DME) 332BC3200X NU Primary

Addresses

Primary practice location

1970 W Arlington Blvd Ste a
Greenville, NC 27834-5783

Mailing address

106 Medical Dr
Elizabeth City, NC 27909-3361

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171219000358 NC DME Supplier - Medical Supply Company With Orthotic-ProstheticDME Supplier - Pedorthic Personnel 1355460254 Practice locations: Greenville, NC

Other NPIs with the same Medicare PAC ID 4

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
Albemarle Orthotics & Prosthetics1970 W Arlington Blvd, Greenville, NC 27834-5783(252) 378-9770 Contracture Treatment Devices: Dynamic Splint|Canes and/or Crutches|Walkers|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, 1998

National Provider Directory

National Provider Directory
Tax ID family
Albemarle Orthotics Prosthetics Inc3 organizations share this tax ID, including this one
Part of
Albemarle Orthotics Prosthetics Inc

Other organizations with this tax ID 2

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

Locations

103 NC Highway 42 W
Ahoskie, NC 27910
Phone (252) 332-4334

1102 Brown St
Washington, NC 27889
Phone (252) 623-2200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607472000000",
    "number": "1912437930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 MEDICAL DR",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 W ARLINGTON BLVD STE A",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345783",
            "telephone_number": "252-378-9770",
            "fax_number": "252-378-9880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBEMARLE ORTHOTICS & PROSTHETICS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALBEMARLE ORTHOTICS & PROSTHETICS, INC.",
        "enumeration_date": "2017-06-13",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A",
        "authorized_official_last_name": "WILLIAMSON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-338-3002",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; 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.