Personalized Prosthetics

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

PERSONALIZED PROSTHETICS

Practice address

628 S Presa St # 5
San Antonio, TX 78210-1054

Phone

(210) 802-8313

NPI assigned

Jan 6, 2017

Organization subpart

No

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

Authorized official

Name

Colette Shrader, MS, CCANPI 1730455676

Title

Owner

Phone

(210) 802-8313

Specialties & licenses 2

Addresses

Other identifiers 1

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.

• Colette Jeanann Shrader, MS

  • Anaplastologist
  • San Antonio, TX
  • NPI 1730455676
  NPD Authorized official

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

{
    "created_epoch": "1483660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595289600000",
    "number": "1952847592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 S PRESA ST # 5",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782101054",
            "telephone_number": "210-802-8313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 S PRESA ST # 5",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782101054",
            "telephone_number": "210-802-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONALIZED PROSTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-06",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A",
        "authorized_official_last_name": "SHRADER",
        "authorized_official_first_name": "COLETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-802-8313",
        "authorized_official_credential": "MS, CCA"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377522301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary-McKinley Person
• William Person, MPT
• Personal Care Management, Inc
• Personal Transformation Wellness Group, Inc.
• Personalized Prescription Physicians, LLC
• Angela D Persyn, PHARMD
• Blair Persyn, MS, RDN, LDN, CNSC
• Deborah Mercy Persyn, RN, IBCLC
• Marie Cecilia Perusek, M.D.
• Muhammad Pervez

• Prosthetic/Orthotic Supplier in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Prosthetic/Orthotic Supplier in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.