PEDORTHIC FOOTCARE OF OKLAHOMA (NPI# 1093080905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093080905 |
| Entity Type | Organization |
| Organization Name | PEDORTHIC FOOTCARE OF OKLAHOMA |
| Practice Address |
5100 N Brookline Ave Ste 330 Oklahoma City OK 73112-3603 |
| Practice Telephone | 4059247306 |
| Practice Fax Number | 4056007287 |
| Mailing Telephone | 4059247306 |
| Mailing Fax Number | 4056007287 |
| Enumeration Date | 2012-03-12 |
| Last Update Date | 2012-04-12 |
| Authorized Official Name | MR. KEVIN JAEGER (CERTIFIED & LICENSED PEDORTHIST) |
| Authorized Official Telephone | 4059247306 |
| Authorized Official Credential | CPED, LPED |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | 84 | OK | Suppliers |
| Street Address |
5100 N BROOKLINE AVE STE 330 |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73112-3603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992886998 | Kevin A Jaeger | Specialist | 5100 N Brookline Ave Ste 330, Oklahoma City, OK 73112-3603 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972145886 | Crystopher J Long | Physical Therapist | Parkway Post Acute Recovery Center, 6312 N Portland, Oklahoma City, OK 73112 | 2019-10-11 |
| 1700448974 | Joy Healthcare Services of Okc LLC | Home Health | 4200 Perimeter Center Drive, Suite 125, Oklahoma City, OK 73112 | 2019-07-08 |
| 1801380159 | Crysten Cheatwood Do, PC | Obstetrics & Gynecology | 3433 Nw 56 Street, Suite 210b, Oklahoma City, OK 73112 | 2018-06-20 |
| 1306352521 | Victoria Ann Kappel | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3466 Nw 56th St. Suite 760, Oklahoma City, OK 73112 | 2017-12-26 |
| 1871014886 | Tanesia Michelle Smith | Case Management | 2629 W I44 Service Rd, Suite 202, Oklahoma City, OK 73112 | 2017-06-29 |
| 1619414257 | Edwige Gwanyama | Student in an Organized Health Care Education/Training Program | 2401 Nw 39 Th Expy Ste 103, Oklahoma City, OK 73112 | 2017-01-20 |
| 1619424017 | Jennifer Beaver | Peer Specialist | 2808 Nw 31st, Oklahoma City, OK 73112 | 2016-09-02 |
| 1417305368 | Gabriel Plank | Counselor | 3000 Founders Blvd Suite239, Oklahoma City, OK 73112 | 2016-06-01 |
| 1912364365 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 4101 N May Ave, Oklahoma City, OK 73112 | 2016-01-15 |
| 1679938922 | Portland Anesthesia Associates LLC | Nurse Anesthetist, Certified Registered | 5501 N Porland Ave, Oklahoma City, OK 73112 | 2015-12-30 |
| Find all providers in zip 73112 | ||||
| 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 |
|---|---|---|---|---|
| 1619515541 | Lamoor Beauty Supply | Prosthetic/Orthotic Supplier | 2214 N Martin Luther King Ave, Oklahoma City, OK 73111-2404 | 2019-12-10 |
| 1598258378 | Otto Bock Orthopedic Services LLC | Prosthetic/Orthotic Supplier | 5601 Nw 72nd Street, Suite 257, Oklahoma City, OK 73132-5920 | 2018-06-07 |
| 1639577885 | La Fuente Prosthetics | Prosthetic/Orthotic Supplier | 229 N.w. 9th Street, Oklahoma City, OK 73102 | 2014-12-19 |
| 1881937977 | Celerity Prosthetics, LLC | Prosthetic/Orthotic Supplier | 8625 S Walker Ave, Oklahoma City, OK 73139-9462 | 2013-03-27 |
| 1427376193 | Genuine Care Rehabilitation Service Inc. | Prosthetic/Orthotic Supplier | 7510 Broadway Ext, Suite 204, Oklahoma City, OK 73116-9031 | 2010-05-05 |
| 1942490784 | Hi Fashion Wigs LLC | Prosthetic/Orthotic Supplier | 1133 North May Ave. Ss, Oklahoma City, OK 73107-5335 | 2007-07-27 |
| 1164551479 | Hair2wear, LLC | Prosthetic/Orthotic Supplier | 11624 Willow Way, Oklahoma City, OK 73162-2046 | 2007-03-04 |
| 1740366210 | Revelation Enterprises Inc | Prosthetic/Orthotic Supplier | 2122 W Reno Ave, Oklahoma City, OK 73107-7028 | 2006-10-27 |
| 1124075833 | Scott Sabolich Prosthetic & Research LLC | Prosthetic/Orthotic Supplier | 10201 Broadway Ext, Oklahoma City, OK 73114-6217 | 2006-05-28 |
| 1881672707 | Compton Shoe Inc | Prosthetic/Orthotic Supplier | 3703 Nw 50th St, Oklahoma City, OK 73112-2553 | 2006-01-03 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73112 |
Please comment or provide details below to improve the information on PEDORTHIC FOOTCARE OF OKLAHOMA.
| 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.