Aedificare, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

AEDIFICARE, LLC

Doing business as

Agility Prosthetics & Orthotics

Practice address

347 W Obrien Dr Ste 1
Hagatna, GU 96910-5050

Phone

(671) 682-0140

Fax

(671) 969-2726

NPI assigned

Jan 30, 2021

Last updated

Mar 20, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dianna M Le, CPO, MSOPNPI 1376188920

Title

Clinician, Owner

Phone

(671) 682-0140

Specialties & licenses 1

Addresses

Other names 1

• Agility Prosthetics & Orthotics Doing business as

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.

• Dianna M Le, CPO, MSOP

  • Prosthetist
  • Hagatna, GU
  • NPI 1376188920
  NPD Authorized official

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

{
    "created_epoch": "1611964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1922699156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1733",
            "city": "HAGATNA",
            "state": "GU",
            "postal_code": "969321733",
            "telephone_number": "671-682-0140",
            "fax_number": "671-969-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 W OBRIEN DR STE 1",
            "city": "HAGATNA",
            "state": "GU",
            "postal_code": "969105050",
            "telephone_number": "671-682-0140",
            "fax_number": "671-969-2726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEDIFICARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-30",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "DIANNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINICIAN, OWNER",
        "authorized_official_telephone_number": "671-682-0140",
        "authorized_official_credential": "CPO, MSOP"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Agility Prosthetics & Orthotics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Agility Prosthetics & Orthotics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tasi Ann Guerrero Ada, PT, DPT, CSCS
• McEllen Ayako Alfred, LCSW
• Jobeth San Nicolas Aquino, M.A., MFT-124
• Steve Anthony Arthur, DC
• Thomas Babauta, MSW, ACSW,QCSW,IMFT
• Lisa V. Baza

• Prosthetic/Orthotic Supplier in Hagatna, GU
• Providers in Hagatna, GU by specialty
• Prosthetic/Orthotic Supplier in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.