Douglass Cert Pros & Orthotics, Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

DOUGLASS CERT PROS & ORTHOTICS, INC

Practice address

4509 Talbot Rd S Ste 103
Renton, WA 98055-6294

Phone

(425) 547-4070

Fax

(425) 547-4071

NPI assigned

Mar 2, 2023

Last updated

Apr 6, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

HANGER INCAs reported in NPPES

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

Authorized official

Name

Jennifer L Simmons

Title

Regulatory Compliance Analyst III

Phone

(206) 414-2907

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Douglass Cert Pros & Orthotics, Inc

  • Prosthetic/Orthotic Supplier
  • Shoreline, WA
  • NPI 1992743090

  9739209925

  Same PAC ID

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

Tax ID family

Douglass Cert Pros Orthotics Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Douglass Cert Pros & Orthotics, Inc

  • Prosthetic/Orthotic Supplier
  • Shoreline, WA
  • NPI 1992743090
  NPD tax ID

Locations

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.

• Glen Stephen Ellis, C.P.O.

  • Specialist
  • Castro Valley, CA
  • NPI 1023156130
  NPD

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

{
    "created_epoch": "1677715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775433600000",
    "number": "1912606583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650846",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4509 TALBOT RD S STE 103",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980556294",
            "telephone_number": "425-547-4070",
            "fax_number": "425-547-4071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLASS CERT PROS & ORTHOTICS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HANGER INC",
        "enumeration_date": "2023-03-02",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "REGULATORY COMPLIANCE ANALYST III",
        "authorized_official_telephone_number": "206-414-2907"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omar K Dorzi, MD
• Kelsey Dosh, RDN
• Douglas Sullivan, PC (Sullivan Chiropractic)
• Olivia Douglas
• Robert M Douglas, M.D.
• Janine A Douglass, OT
• Nicolle Dourte, LMP
• Shane G. Dowling, PA-C
• Kelsey Elizabeth Downing, ATC, MAT, LAT, CSCS
• Carlin Doyle, PA-C

• Prosthetic/Orthotic Supplier in Renton, WA
• Providers in Renton, WA by specialty
• Prosthetic/Orthotic Supplier in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; 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.