PRO BALANCE LLC (NPI# 1104012319) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104012319 |
| Entity Type | Organization |
| Organization Name | PRO BALANCE LLC |
| Practice Address |
2408 Fort Henry Drive Kingsport TN 37664 |
| Practice Telephone | 4232467272 |
| Practice Fax Number | 4232462803 |
| Mailing Telephone | 4232467272 |
| Mailing Fax Number | 4232462803 |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2008-01-07 |
| Authorized Official Name | MRS. GILGIA PRUMBS (MEMBER) |
| Authorized Official Telephone | 4232467272 |
| Authorized Official Credential | PT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | PRO16 | TN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1454327 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700288974 | Pro Balance LLC | Clinic/Center | 2408 Fort Henry Dr, Kingsport, TN 37664-3708 | 2014-09-19 |
| Street Address |
2408 FORT HENRY DRIVE |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972067395 | Alice Victoria Lilly | Nurse Practitioner | 2995 Ft. Henry Drive, Suite 100, Kingsport, TN 37664 | 2019-01-30 |
| 1861966525 | Catherine Ann Hensley | Nurse Practitioner | 2995 Fort Henry Drive, Suite 100, Kingsport, TN 37664 | 2019-01-16 |
| 1679076954 | Christopher A Hillman | Dentist | 1599 Fort Henry Dr Ste 102, Kingsport, TN 37664 | 2018-03-13 |
| 1154666733 | Cristin Patterson | Counselor | 2762 East Center St., Kingsport, TN 37664 | 2012-12-07 |
| 1972851095 | Kevin Michael Smith | Pharmacist | 1425 East Center Street, Kingsport, TN 37664 | 2012-08-21 |
| 1619299617 | Kelli Lynn Dillon | Counselor | 1570 Waverly Rorad, Kingsport, TN 37664 | 2010-02-18 |
| 1356503726 | Charles Craig Stieler | Hearing Instrument Specialist | 2101 Ft Henry Dr, Kingsport, TN 37664 | 2008-06-27 |
| 1518188648 | Remington House | Assisted Living Facility | 640 Rock Springs Road, Kingsport, TN 37664 | 2007-05-02 |
| 1689795007 | Elaine Frazier | Emergency Medicine | 410 Golf Ridge Dr, Kingsport, TN 37664 | 2007-04-03 |
| 1306961487 | Timothy Ross Martin | Dentist | 1599 Fort Henry Drive, Kingsport, TN 37664 | 2007-03-20 |
| Find all providers in zip 37664 | ||||
| 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 |
|---|---|---|---|---|
| 1841761947 | Mac's Medicine Mart Dba Unique Boutique | Prosthetic/Orthotic Supplier | 1455 E Center St Ste 2b, Kingsport, TN 37664-2501 | 2018-12-16 |
| 1023368180 | Achieve Bracing | Prosthetic/Orthotic Supplier | 1732 N Eastman Rd Ste 1a, Kingsport, TN 37664-2376 | 2012-09-17 |
| 1154653830 | Southern Orthotics & Prosthetics | Prosthetic/Orthotic Supplier | 1567 N Eastman Rd Ste 4, Kingsport, TN 37664-2680 | 2010-02-05 |
| 1740373661 | Jason D Joyce | Prosthetic/Orthotic Supplier | 1567 N Eastman Rd, Suite 4, Kingsport, TN 37664-2683 | 2006-10-02 |
| 1528167509 | Custom Orthotics & Prosthetics | Prosthetic/Orthotic Supplier | 1567 North Eastman Rd, Ste 4, Kingsport, TN 37664-2680 | 2006-09-22 |
| 1982670964 | Appalachian Prosthetic & Orthotic Services, Inc | Prosthetic/Orthotic Supplier | 3551 E Stone Dr, Kingsport, TN 37660-7115 | 2006-02-28 |
| 1992257745 | Excel Prosthetics & Orthotics, Inc | Prosthetic/Orthotic Supplier | 121 E Ravine Rd, Suite 400, Kingsport, TN 37660 | 2016-10-27 |
| 1437563665 | Bristol Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 921 Broad St, Kingsport, TN 37660-3801 | 2014-06-16 |
| 1518238278 | Finer Things for Her | Prosthetic/Orthotic Supplier | 1880 N Eastman Rd, Suite 230, Kingsport, TN 37664-2312 | 2012-01-25 |
| 1891935763 | Victory Orthotics & Prosthetics LLC | Prosthetic/Orthotic Supplier | 2 Sheridan Sq, Suite 100, Kingsport, TN 37660 | 2009-03-04 |
| Find all providers in KINGSPORT | ||||
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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.