Susquehanna Valley Prosthetics & Orthotics Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

SUSQUEHANNA VALLEY PROSTHETICS & ORTHOTICS INC

Practice address

3120 N Old Trail
Shamokin Dam, PA 17876

Phone

(570) 743-1414

Fax

(570) 743-5215

NPI assigned

Sep 13, 2005

Organization subpart

Yes

Parent organization

SUSQUEHANNA VALLEY PROSTHETICS & ORTHOTICS INCAs reported in NPPES

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

Authorized official

Name

Mr. Frank Thomas Dominick III, CPNPI 1912247198

Title

Owner Certified Prosthetist

Phone

(570) 743-1414

Specialties & licenses 1

Addresses

Other identifiers 11

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Frank T Dominick III, C.P.

  • Prosthetic/Orthotic Supplier
  • Williamsport, PA
  • NPI 1912247198
  NPD (past) Authorized official

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199318400000",
    "number": "1932194271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 243",
            "city": "SHAMOKIN DAM",
            "state": "PA",
            "postal_code": "17876",
            "telephone_number": "570-743-1414",
            "fax_number": "570-743-5215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 N OLD TRAIL",
            "city": "SHAMOKIN DAM",
            "state": "PA",
            "postal_code": "17876",
            "telephone_number": "570-743-1414",
            "fax_number": "570-743-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSQUEHANNA VALLEY PROSTHETICS & ORTHOTICS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUSQUEHANNA VALLEY PROSTHETICS & ORTHOTICS INC",
        "enumeration_date": "2005-09-13",
        "last_updated": "2008-01-03",
        "status": "A",
        "authorized_official_last_name": "DOMINICK",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER CERTIFIED PROSTHETIST",
        "authorized_official_telephone_number": "570-743-1414",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "CP"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA",
            "identifier": "116173",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "SU206824",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2477665",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA",
            "identifier": "340622",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN",
            "identifier": "39HA76",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "SU206824",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018173000003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1511123",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ABP ADMINISTRATION",
            "identifier": "28389",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "39HA76",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH PLAN",
            "identifier": "57492",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katelynn Sola
• Kareema Rhonda Stansbury
• Robin Lee Steele, PT
• Nikki Marie Styer
• Susquehanna Valley Foot and Ankle Center, Inc
• Kristi Swartz
• Brittany Nicole Swope
• The Bernstein Hilliker Hartzell Optical Shop
• Britney Toborg
• Martina Uskurait

• Prosthetic/Orthotic Supplier in Shamokin Dam, PA
• Providers in Shamokin Dam, PA by specialty
• Prosthetic/Orthotic Supplier in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; 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.