SCOTT SABOLICH PROSTHETIC & RESEARCH LLC (NPI# 1124075833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124075833 |
| Entity Type | Organization |
| Organization Name | SCOTT SABOLICH PROSTHETIC & RESEARCH LLC |
| Practice Address |
10201 Broadway Ext Oklahoma City OK 73114-6217 |
| Mailing Address |
Po Box 16231 Oklahoma City OK 73113-2231 |
| Practice Telephone | 4054630203 |
| Practice Fax Number | 4054630251 |
| Mailing Telephone | 4054630203 |
| Mailing Fax Number | 4054630251 |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2011-10-31 |
| Authorized Official Name | SCOTT A SABOLICH (OWNER) |
| Authorized Official Telephone | 4058416800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | CP2626 | OK | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100812550A | 05 |
| Street Address |
10201 BROADWAY EXT |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73114-6217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124669783 | Heather Williams | Occupational Therapist | 1404 Nw122nd St, Oklahoma City, OK 73114 | 2019-10-04 |
| 1477194033 | Shonta Jones | Technician | 10723 Norh Western, Apartment G, Oklahoma City, OK 73114 | 2019-10-04 |
| 1023537644 | Tracye Carter | Registered Nurse | 812 Nw 121 Terr, Oklahom City, OK 73114 | 2017-09-14 |
| 1003362849 | Randy Joshua Williamson | Behavioral Analyst | 101 Bainbridge Rd, Oklahoma City, OK 73114 | 2016-08-31 |
| 1427413368 | John Adrian Howard | Physical Therapist | 13100 N Western Ave Ste 302, Oklahoma City, OK 73114 | 2015-12-18 |
| 1497150197 | Payam Ishani Afousi | Dentist | 9405 N. Penn Place, Casady Square, Oklahoma City, OK 73114 | 2014-10-24 |
| 1922407386 | Kelvin Hughes | Counselor | 1400 Nw 105th Ter, Oklahoma City, OK 73114 | 2014-08-21 |
| 1285056887 | Malarie Jackson | Nurse Practitioner | 609 W. Memorial Rd., Oklahoma City, OK 73114 | 2014-01-16 |
| 1508108705 | Adam Liberty | Community/Behavioral Health | 428 N.w 81st, Oklahoma City, OK 73114 | 2013-03-26 |
| 1780926345 | Michelle D Hardimon | Behavioral Analyst | 700 Ne 122nd Apt 4509, Oklahoma City, OK 73114 | 2013-03-21 |
| Find all providers in zip 73114 | ||||
| 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 |
| 1881672707 | Compton Shoe Inc | Prosthetic/Orthotic Supplier | 3703 Nw 50th St, Oklahoma City, OK 73112-2553 | 2006-01-03 |
| 1679568125 | Tim Carlton Prosthetics Inc. | Prosthetic/Orthotic Supplier | 9414 Westgate Rd, Suite B., Oklahoma City, OK 73162-6245 | 2005-09-12 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73114 |
Please comment or provide details below to improve the information on SCOTT SABOLICH PROSTHETIC & RESEARCH LLC.
| 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.