Susquehanna Valley Prosthetics & Orthotics, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

6000007253 Issued in PA

Legal business name

SUSQUEHANNA VALLEY PROSTHETICS & ORTHOTICS, INC.

Practice address

6850 Lows Rd
Suite 220
Bloomsburg, PA 17815-8729

Phone

(570) 387-1711

Fax

(570) 387-1766

NPI assigned

Sep 4, 2008

Last updated

Sep 4, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

SUSQUEHANNA VALLEY PROSTHETICS & ORTHOTICS, INC.As reported in NPPES

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

Authorized official

Name

Mr. Frank T Dominick, CP

Title

Owner/ Prosthetist

Phone

(570) 743-1414

Specialties & licenses 1

Addresses

Other identifiers 8

Part of

Susquehanna Valley Prosthetics Orthotics Inc

Locations

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220486400000",
    "number": "1962650739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6850 LOWS RD",
            "address_2": "SUITE 220",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178158729",
            "telephone_number": "570-387-1711",
            "fax_number": "570-387-1766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6850 LOWS RD",
            "address_2": "SUITE 220",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178158729",
            "telephone_number": "570-387-1711",
            "fax_number": "570-387-1766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSQUEHANNA VALLEY PROSTHETICS & ORTHOTICS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUSQUEHANNA VALLEY PROSTHETICS & ORTHOTICS, INC.",
        "enumeration_date": "2008-09-04",
        "last_updated": "2008-09-04",
        "status": "A",
        "authorized_official_last_name": "DOMINICK",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER/ PROSTHETIST",
        "authorized_official_telephone_number": "570-743-1414",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CP"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "PA",
            "license": "6000007253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIMENSIONS",
            "identifier": "28389",
            "state": "PA"
        },
        {
            "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": "CAPITAL BLUE CROSS",
            "identifier": "39HA76",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA",
            "identifier": "116173",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH PLAN",
            "identifier": "1511123",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2477665",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN",
            "identifier": "39HA76",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susquehanna Physical Therapy Associates, Inc. (Susquehanna Physical Therapy)
• Susquehanna Surgery Center Inc
• Susquehanna Valley Diagnostic Imaging Inc.
• Susquehanna Valley Medical Specialties
• Susquehanna Valley Medical Specialties, PC
• Nicole L Svensson, RN
• James Joseph Swantek II, BS
• Dawn M Sweeney
• Ondrea Talanca
• Troy Tanner, PHARMD

• Prosthetic/Orthotic Supplier in Bloomsburg, PA
• Providers in Bloomsburg, 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 Sep 4, 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.