PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES- WEST, LLC (NPI# 1225430150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225430150 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES- WEST, LLC |
| Practice Address |
1275 E Fairfax Rd Salt Lake City UT 84103-4324 |
| Mailing Address |
Po Box 865109 Orlando FL 32886-5109 |
| Practice Telephone | 8015363820 |
| Practice Fax Number | 8015363731 |
| Mailing Telephone | 8446023960 |
| Mailing Fax Number | 8132818461 |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2015-07-23 |
| Authorized Official Name | DAVID R DRAPER (DIRECTOR) |
| Authorized Official Telephone | 8015363827 |
| Authorized Official Credential | CPO |
| Is Organization Subpart | Y |
| Parent Organization Name | PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES- WEST, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | UT | Suppliers |
| Street Address |
1275 E FAIRFAX RD |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84103-4324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669611935 | Jaime E Manning | Physician Assistant | 1275 E Fairfax Rd, Salt Lake City, UT 84103-4324 | 2009-02-11 |
| 1528556776 | Shriners Hospitals for Children | Anesthesiology | 1275 E Fairfax Rd, Salt Lake City, UT 84103 | 2018-04-24 |
| 1356888119 | Amy Shuckra | Physical Therapist | 1275 E Fairfax Rd, Salt Lake City, UT 84103-4324 | 2017-01-31 |
| 1508223686 | David Draper | Orthotist | 1275 E Fairfax Rd, Salt Lake City, UT 84103-4324 | 2016-01-21 |
| 1396187282 | Shriners Hospitals for Children | Orthopaedic Surgery | 1275 E Fairfax Rd, Salt Lake City, UT 84103-4324 | 2013-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932509213 | Paul David Rauch | Specialist/Technologist | 701 De Soto Street, Salt Lake City, UT 84103 | 2014-08-24 |
| 1073866695 | University Neuropsychiatric Institute | Community Based Residential Treatment Facility, Mental Illness | 252 South 500 East, Salt Lake City, UT 84103 | 2012-10-19 |
| 1114285558 | Christopher John Murphy | Student in an Organized Health Care Education/Training Program | 585 1st Ave, Salt Lake City, UT 84103 | 2012-04-23 |
| 1447573266 | Peter Louis Kapelke | Specialist | Fairfax Rd. @ Virginia St., Shriners Hospital Salt Lake City, Salt Lake City, UT 84103 | 2010-03-08 |
| 1578763389 | Susana Auhangamea Kinikini | Nurse Practitioner | Fairfax @ Virginia Street, Salt Lake City, UT 84103 | 2007-07-19 |
| 1609082320 | Cynthia N Shumway | Social Worker | 580 10th Avenue, Salt Lake City, UT 84103 | 2007-05-16 |
| 1811010655 | Kent Walker Farnsworth | Obstetrics & Gynecology | 1509 Federal Heights Drive, Salt Lake City, UT 84103 | 2007-04-09 |
| 1912082421 | Eloise Agnes Maughan | Nurse Practitioner | 324 8th Ave, Lds Hospital, Salt Lake City, UT 84103 | 2006-10-25 |
| 1407968464 | Kit D Smith | Anesthesiology | 359 - 8th Avenue, Asc, Salt Lake City, UT 84103 | 2006-08-31 |
| 1396854113 | Lisa H Carter | Physical Therapist | 1285 East Fairfax Road, Salt Lake City, UT 84103 | 2006-08-29 |
| Find all providers in zip 84103 | ||||
| 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 |
|---|---|---|---|---|
| 1871729939 | Specialized Orthotic & Prosthetic Technologies | Prosthetic/Orthotic Supplier | 5292 College Dr Ste 103, Salt Lake City, UT 84123-2958 | 2009-06-03 |
| 1649496134 | Ability Prosthetic Systems, Inc. | Prosthetic/Orthotic Supplier | 750 E 100 S, Salt Lake City, UT 84102-4107 | 2007-04-17 |
| 1164418505 | Wasatch Orthotics & Pedorthics, LLC | Prosthetic/Orthotic Supplier | 887 E Vine St, Salt Lake City, UT 84107-6515 | 2005-09-21 |
| 1972538536 | Nordstrom | Prosthetic/Orthotic Supplier | 50 S Main St, Salt Lake City, UT 84144-0103 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578035713 | Feminine Forms LLC | Prosthetic/Orthotic Supplier | 345 S 500 E, American Fork, UT 84003-2525 | 2018-12-28 |
| 1841761095 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 4225 W Lake Park Blvd Ste 225, West Valley City, UT 84120-8213 | 2018-12-16 |
| 1114441441 | Asd Sleep LLC | Prosthetic/Orthotic Supplier | 1957 W Royal Hunte Dr, #250, Cedar City, UT 84720 | 2017-07-28 |
| 1992226302 | Freedom Prosthetic & Orthotics, LLC | Prosthetic/Orthotic Supplier | 356 E 600 S, St George, UT 84770-3949 | 2017-07-06 |
| 1356792634 | Fit Prosthetics LLC | Prosthetic/Orthotic Supplier | 154 E Myrtle Ave, Suite #100, Murray, UT 84107-4849 | 2016-06-28 |
| 1750760369 | Women Restore LLC | Prosthetic/Orthotic Supplier | 1171 Expressway Ln, Spanish Fork, UT 84660-1331 | 2015-05-28 |
| 1114306891 | Northwest Orthotics & Prosthetics | Prosthetic/Orthotic Supplier | 642 Kirby Ln Ste 103, Spanish Fork, UT 84660-5753 | 2015-05-27 |
| 1457752503 | Eaze Bracing | Prosthetic/Orthotic Supplier | 1324 W 7125 S, West Jordan, UT 84084 | 2014-09-09 |
| 1851686588 | Walking Comfort LLC. | Prosthetic/Orthotic Supplier | 627 W. Marketplace Dr., Centerville, UT 84014-0000 | 2011-06-10 |
| 1205155777 | Jenco Prosthetics & Orthotics, LLC | Prosthetic/Orthotic Supplier | 7026 South Commerce Park Dr, Suite 2, Midvale, UT 84047-1026 | 2010-05-24 |
| Find all providers with the same taxonomy | ||||
| City | SALT LAKE CITY |
| Zip Code | 84103 |
Please comment or provide details below to improve the information on PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES- WEST, 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.