NPIMap

Organization Active NPI

Pensacola Orthotic & Prosthetic Specialties, Inc

  • Prosthetic/Orthotic Supplier
  • Pensacola, FL
National Provider Identifier
1972812014
Registry record updated Dec 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
ORT17 Issued in FL
Legal business name
PENSACOLA ORTHOTIC & PROSTHETIC SPECIALTIES, INC
Practice address
5855 Creek Station Dr
Pensacola, FL 32504-8626
Phone
(850) 478-7676
Fax
(850) 478-7699
NPI assigned
Oct 6, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2010

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

Authorized official

Name
Thomas D Deckert, C.O.
Title
President
Phone
(850) 478-7676

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X ORT17 FL Primary

Addresses

Primary practice location

5855 Creek Station Dr
Pensacola, FL 32504-8626

Mailing address

5855 Creek Station Dr
Pensacola, FL 32504-8626
Phone (850) 478-7676

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1286323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291334400000",
    "number": "1972812014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 CREEK STATION DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048626",
            "telephone_number": "850-478-7676",
            "fax_number": "850-478-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5855 CREEK STATION DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048626",
            "telephone_number": "850-478-7676",
            "fax_number": "850-478-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENSACOLA ORTHOTIC & PROSTHETIC SPECIALTIES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-06",
        "last_updated": "2010-12-03",
        "status": "A",
        "authorized_official_last_name": "DECKERT",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-478-7676",
        "authorized_official_credential": "C.O."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "FL",
            "license": "ORT17",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2010; 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.