Prosthetic Design Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

PROSTHETIC DESIGN INC

Doing business as

Orthotic & Prosthetic Design Inc

Practice address

2665 Scott Ave Ste E
Saint Louis, MO 63103-3023

Phone

(314) 535-5359

Fax

(314) 535-5488

NPI assigned

May 1, 2023

Organization subpart

No

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

Authorized official

Name

Mark Wilson

Title

Owner/President

Phone

(314) 535-5359

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ORTHOTIC & PROSTHETIC DESIGN INC Doing business as

Locations

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

{
    "created_epoch": "1682899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682899200000",
    "number": "1982392510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2665 SCOTT AVE STE E",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631033023",
            "telephone_number": "314-535-5359",
            "fax_number": "314-535-5488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2665 SCOTT AVE STE E",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631033023",
            "telephone_number": "314-535-5359",
            "fax_number": "314-535-5488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSTHETIC DESIGN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-01",
        "last_updated": "2023-05-01",
        "certification_date": "2023-04-20",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "314-535-5359"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "624794301",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ORTHOTIC & PROSTHETIC DESIGN INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Prosperity Healthcare LLC
• Theresa Rose Prosser, PHARM.D.
• Daniel J Prost, CRNA
• Prosthetic and Orthotic Care LLC (P & O Care)
• Prosthetic Design Inc (Orthotic & Prosthetic Design Inc)
• Rachel Protzel, MSW, LCSW
• Anele M Proudfoot, AA-C
• Rosa M. Prouhet, CNP
• Elizabeth Provencio
• Provide Dental

• Prosthetic/Orthotic Supplier in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Prosthetic/Orthotic Supplier in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; 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.