CUSTOM HEALTHCARE, LLC (NPI# 1093017642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093017642 |
| Entity Type | Organization |
| Organization Name | CUSTOM HEALTHCARE, LLC |
| Other Organization Name | PPS ORTHOTIC & PROSTHETIC SERVICES |
| Practice Address |
1508 N Thornton Ave Ste 104 Dalton GA 30720-8516 |
| Mailing Address |
3700 Brainerd Rd Chattanooga TN 37411-3603 |
| Practice Telephone | 7065297651 |
| Practice Fax Number | 7065297680 |
| Mailing Telephone | 4236970057 |
| Mailing Fax Number | 4236489366 |
| Enumeration Date | 2010-12-01 |
| Last Update Date | 2010-12-01 |
| Authorized Official Name | MR. JAMES C ROGERS (CEO) |
| Authorized Official Telephone | 4236970057 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| Other Name | Type Code |
|---|---|
| PPS Orthotic & Prosthetic Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588122394 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 1101 Old Creek Rd Ste A1, Athens, GA 30607-1090 | 2019-03-11 |
| 1366900391 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 410 Dromedary St, Woodbury, GA 30293-3560 | 2019-03-08 |
| 1326511643 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 110 Palmetto Pkwy, Belton, SC 29627-2126 | 2019-01-09 |
| 1285109645 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 48 Morrison Ln, Ringgold, GA 30736-7277 | 2018-10-11 |
| 1083195663 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 902 12th St Ste B, Phenix City, AL 36867-5827 | 2018-08-22 |
| 1538437215 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 201 Center Park Dr Ste 1000, Knoxville, TN 37922-2105 | 2011-12-08 |
| 1770863532 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 806 Ulrich Ave, Louisville, KY 40219-1846 | 2011-08-25 |
| 1952451296 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2150 N Ocoee St Ste C, Cleveland, TN 37311-3936 | 2007-01-11 |
| 1730481383 | Custom Healthcare, LLC | Prosthetic/Orthotic Supplier | 2400 E Andrew Johnson Hwy, Greeneville, TN 37745-0948 | 2010-12-01 |
| 1275583783 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 3700 Brainerd Rd, Chattanooga, TN 37411-3603 | 2006-05-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | CUSTOM HEALTHCARE, LLC | 3700 Brainerd Rd, Chattanooga, TN 37411 |
| Street Address |
1508 N THORNTON AVE STE 104 |
| City | DALTON |
| State | GA |
| Zip Code | 30720-8516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356508972 | Jennifer Dark Starnes | Emergency Medicine | 1508 N Thornton Ave, Dalton, GA 30720-8516 | 2008-05-21 |
| 1568819423 | Heather Sue Lyles | Physical Therapist | 1508 N Thornton Ave, Ste 106, Dalton, GA 30720-8516 | 2016-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528688421 | Nighat Purnima Kabir | Student in an Organized Health Care Education/Training Program | Hamilton Medical Center, Attn: Residency Program, 1200 Memorial Drive, Dalton, GA 30720 | 2020-04-21 |
| 1720620727 | Elizabeth Nicole Gregory | Behavioral Analyst | 1201 Burleyson Rd., Dalton, GA 30720 | 2019-10-10 |
| 1972161768 | Andrea Nicole Henry | Speech-Language Pathologist | 1201 Burleyson Road, Dalton, Ga. 30720, Dalton, GA 30720 | 2019-06-05 |
| 1275056905 | Cynthia L Wood | Speech-Language Pathologist | 1011 Professional Blvd., Dalton, GA 30720 | 2017-07-25 |
| 1073069225 | Alyssa Sellers Garner | Nurse Practitioner | 1436 Chattanooga Avenue, Dalton, GA 30720 | 2016-08-28 |
| 1588039077 | Katie Walker | Social Worker | 900 Shugart Road, Dalton, GA 30720 | 2015-12-09 |
| 1215310800 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 98 West Walnut Ave, Dalton, GA 30720 | 2015-07-01 |
| 1275969081 | Stacy Kay Whitehead | Nurse Practitioner | 1411 Chattanooga Avenue, Suite 101, Dalton, GA 30720 | 2013-09-25 |
| 1821439985 | Chantal Aneka Raheeda Lewis | Internal Medicine | 1109 Burleyson Rd Ste 103, Dalton, GA 30720 | 2013-07-17 |
| 1174960678 | Homestead Hospice of Northwest Georgia, LLC | Hospice Care, Community Based | 1601 Hickory Street, Dalton, GA 30720 | 2013-05-24 |
| Find all providers in zip 30720 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780773291 | The Perfect Fit Salon Inc | Prosthetic/Orthotic Supplier | 1300 North Thornton Rd, Suite B, Dalton, GA 30720 | 2006-10-12 |
| 1881678522 | Stubbs Prosthetics & Orthotics, Inc. | Prosthetic/Orthotic Supplier | 1004 Burleyson Rd, Dalton, GA 30720-8340 | 2005-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548860810 | Crowns of Love Inc | Prosthetic/Orthotic Supplier | 707 Park Ave Ne Apt 1382, Atlanta, GA 30326-3410 | 2020-10-27 |
| 1447860150 | Shadae Renee Medical Wigs | Prosthetic/Orthotic Supplier | 10719 Alpharetta Hwy # 1792, Roswell, GA 30076-2432 | 2020-08-06 |
| 1114535432 | Beauty Zone2 Medical Wigs | Prosthetic/Orthotic Supplier | 252 Keys Ferry St, Mcdonough, GA 30253-3342 | 2020-07-22 |
| 1619594389 | Legally Laced | Prosthetic/Orthotic Supplier | 1000 Corporate Pointe Ste 214, Warner Robins, GA 31088-3440 | 2020-06-29 |
| 1093332009 | Jazzy Wigs, Rx | Prosthetic/Orthotic Supplier | 59 Urey Emerson Dr, Richland, GA 31825-6636 | 2020-06-25 |
| 1174147938 | Salon Asya Mignon LLC | Prosthetic/Orthotic Supplier | 4290 Memorial Dr Ste B1, Decatur, GA 30032-1225 | 2020-06-07 |
| 1023630928 | Michelles Beauty Bar | Prosthetic/Orthotic Supplier | 3662 Druid Oaks Dr, Valdosta, GA 31605-6542 | 2020-05-13 |
| 1366063596 | Stylish Styles By Tee | Prosthetic/Orthotic Supplier | 6595 Roswell Rd Ste G1169, Atlanta, GA 30328-3152 | 2020-04-28 |
| 1518503432 | Regina Murff-love | Prosthetic/Orthotic Supplier | 341 Indus Ln, Lawrenceville, GA 30044-3835 | 2019-11-26 |
| 1417508995 | Priscilla Denise Brown | Prosthetic/Orthotic Supplier | 38200 3rd Ave, Fort Gordon, GA 30905 | 2019-09-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.