Dream Team Prosthetic, LLC
Organization Active NPI Prosthetic/Orthotic Supplier · Duncan, OK
NPI 1992243752 · NPPES record last updated Feb 1, 2017
Key facts
- NPI
- 1992243752
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Prosthetic/Orthotic Supplier 335E00000X
- License
- LP13 (OK)
- Legal business name
- DREAM TEAM PROSTHETIC, LLC
- Practice address
- 7111 Nix Dr
Duncan, OK 73533-4191 - Phone
- (580) 255-2100
- Fax
- (580) 255-2102
- NPI assigned
- Feb 1, 2017
- Organization subpart
- No
Authorized official
- Name
- Mr. Chad Eric Simpson, BOCP, LP
- Title
- Owner/ Clinical Director
- Phone
- (580) 255-2100
Practitioners 2
-
Chad Simpson, BOCP
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Dream Team Prosthetics LLC |
Limb Prostheses | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170615002389 | OK | DME Supplier - Prosthetic Personnel | 5193093102 | Practice locations: Duncan, OK |
National Provider Directory
Locations
7111 Nix Dr
Duncan, OK 73533
Phone (580) 255-2100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | LP13 | OK | Yes |
Addresses
Primary practice location
7111 Nix Dr
Duncan, OK 73533-4191
Mailing address
7111 Nix Dr
Duncan, OK 73533-4191
Phone (580) 255-2100
Other providers in Duncan, OK
- Kelby Doucet-Maddox
- Dr Donald C Rice Optometrist Inc
- Dr Robert F Miller
- Dr. Jody W. Atchley, Optometrist
- Dr. Timothy P. Walker, Optometrist, Inc.
- DRH Imaging, LLC
- Bryan Kirk Duell
- Adam Duke
- Leslie Duke
- Duncan Anesthesia Associates Inc
All providers in Duncan, OK · Prosthetic/Orthotic Supplier in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.