Custom Orthotics of North Carolina, LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

C18399 Issued in NC

Legal business name

CUSTOM ORTHOTICS OF NORTH CAROLINA, LLC

Practice address

4125 Ben Franklin Blvd
Suite 180
Durham, NC 27704-2167

Phone

(919) 479-5990

Fax

(919) 479-8782

NPI assigned

Jul 17, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Stephen Bradley Deal, BO, CO

Title

Operations Manager, Orthotist

Phone

(919) 479-5990

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932127396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4125 BEN FRANKLIN BLVD",
            "address_2": "SUITE 180",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042167",
            "telephone_number": "919-479-5990",
            "fax_number": "919-479-8782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 BEN FRANKLIN BLVD",
            "address_2": "SUITE 180",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042167",
            "telephone_number": "919-479-5990",
            "fax_number": "919-479-8782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM ORTHOTICS OF NORTH CAROLINA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEAL",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "BRADLEY",
        "authorized_official_title_or_position": "OPERATIONS MANAGER, ORTHOTIST",
        "authorized_official_telephone_number": "919-479-5990",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BO, CO"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NC",
            "license": "C18399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "046P3",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7704266",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nadia Nikol Curtis, LPCA, MA, BS.
• Tyesha Naychae Curtis, LCAS-A
• John Sutter Curtiss II
• Howard Thomas Cusick III, M.D.
• Yuji Payne Cusick, PT
• Jordan Kirsten Cuthbert, M.D.
• Allison Cutler
• Andrew Cutler, M.D.
• Cameron Cutler, RD
• Sammetta Cutler, CADC/CPSS

• Customized Equipment (DME) in Durham, NC
• Providers in Durham, NC by specialty
• Customized Equipment (DME) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.