Idaho Prosthetics & Orthotics, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

IDAHO PROSTHETICS & ORTHOTICS, INC.

Practice address

333 N 18TH Ave Ste B4
Pocatello, ID 83201-3322

Phone

(208) 478-8000

Fax

(208) 478-8801

NPI assigned

Mar 12, 2007

Last updated

Mar 3, 2020By 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

Annette Wright

Title

Office Manager

Phone

(208) 478-8800

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

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

• Idaho Prosthetics & Orthotics, Inc.

  • Prosthetic/Orthotic Supplier
  • Idaho Falls, ID
  • NPI 1760514780

  2961523626

  Same PAC ID
• Idaho Prosthetics & Orthotics, Inc.

  • Prosthetic/Orthotic Supplier
  • Twin Falls, ID
  • NPI 1881228591

  2961523626

  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

Idaho Prosthetics Orthotics Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Idaho Prosthetics & Orthotics, Inc.

  • Prosthetic/Orthotic Supplier
  • Idaho Falls, ID
  • NPI 1760514780
  NPD tax ID
• Idaho Prosthetics & Orthotics, Inc.

  • Prosthetic/Orthotic Supplier
  • Twin Falls, ID
  • NPI 1881228591
  NPD tax ID

Locations

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583193600000",
    "number": "1952433971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N 18TH AVE STE B4",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832013322",
            "telephone_number": "208-478-8000",
            "fax_number": "208-478-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N 18TH AVE STE B4",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832013322",
            "telephone_number": "208-478-8000",
            "fax_number": "208-478-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO PROSTHETICS & ORTHOTICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-478-8800"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805166100",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Idaho Medical Massage LLC
• Idaho Modern Medicine - PLLC
• Idaho Orthopaedics and Sports Clinic
• Idaho Orthopedic & Sports Clinic PA
• Idaho Pathology Laboratory Physicians
• Idaho Regional Hand & Upper Extremity Center PLLC
• Idaho Sport Massage LLC (Idaho Sport Massage)
• Idaho Sports & Spine PLLC
• Idaho State University
• Idaho State University

• Prosthetic/Orthotic Supplier in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Prosthetic/Orthotic Supplier in Idaho

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