COUNTRY COBBLER, LTD. (NPI# 1255681797) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255681797 |
| Entity Type | Organization |
| Organization Name | COUNTRY COBBLER, LTD. |
| Practice Address |
6815 Fayetteville Road #102 Durham NC 27713-7081 |
| Mailing Address |
6815 Fayetteville Road #102 Durham NC 27713 |
| Practice Telephone | 9192480850 |
| Practice Fax Number | 9192480935 |
| Mailing Telephone | 9192480850 |
| Mailing Fax Number | 9192480935 |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2014-05-27 |
| Authorized Official Name | MR. MONTY K. MANTEY (PRESIDENT/OWNDER) |
| Authorized Official Telephone | 9107729994 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | 00992 | NC | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962758714 | Country Cobbler, Ltd. | Prosthetic/Orthotic Supplier | 1001 Airport Blvd, Suite 125, Morrisville, NC 27560-8935 | 2012-07-31 |
| 1821344706 | Country Cobbler, Ltd. | Prosthetic/Orthotic Supplier | 255 N Equity Dr Ste A, Smithfield, NC 27577-6054 | 2012-07-30 |
| 1780646653 | Country Cobbler, Ltd. | Prosthetic/Orthotic Supplier | 3501 Oleander Dr, Suite 11, Wilmington, NC 28403-0824 | 2006-04-05 |
| Street Address |
6815 FAYETTEVILLE ROAD #102 |
| City | DURHAM |
| State | NC |
| Zip Code | 27713-7081 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558977074 | Zoe Wellness | Clinic/Center | 5322 Nc 55, 102, Durham, NC 27713 | 2020-09-21 |
| 1194352542 | Mariah Davis | Counselor | 1822 East Hwy Nc 54, Suite 300, Durham, NC 27713 | 2020-03-25 |
| 1316589138 | Monarch | Community/Behavioral Health | 1513 Piperwood Court, Durham, NC 27713 | 2019-10-14 |
| 1205486081 | Lisa Mesmer Barnes | Nurse Practitioner | 5309hwy 55, Suite 105, Durham, NC 27713 | 2019-09-13 |
| 1497315352 | Mary Therese Wood | Social Worker | 1822 E Highway 54, Suite 300, Durham, NC 27713 | 2019-06-13 |
| 1720558307 | Kevin D Simmons | Counselor | 1822 Nc Hwy 54 Suite 300, Durham, NC 27713 | 2018-11-27 |
| 1790265585 | Kelli Cryer | Counselor | 54 E Nc Hwy 1822, Suite 300, Durham, NC 27713 | 2018-08-21 |
| 1477039253 | Mahavir Rx, LLC | Pharmacy | 6216 Fayetteville Rd Ste 105, Durham, NC 27713 | 2018-07-16 |
| 1811482862 | Tessa Taylor | Dentist | 2515 E Nc Highway 54 Ste 2000, Durham, NC 27713 | 2018-06-22 |
| 1013401579 | Emily Louise Haller | Counselor | 1822 E Hwy 54, Suite 300, Durham, NC 27713 | 2018-06-19 |
| Find all providers in zip 27713 | ||||
| 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 |
|---|---|---|---|---|
| 1821595356 | Joy Leak | Prosthetic/Orthotic Supplier | 605 Bacon St, Durham, NC 27703-5001 | 2018-04-11 |
| 1659656916 | Center for Orthotic and Prosthetic Care of North Carolina, Inc | Prosthetic/Orthotic Supplier | 4702 Creekstone Dr, Durham, NC 27703-8410 | 2011-10-19 |
| 1669607289 | In The Pink Wig Boutique LLC | Prosthetic/Orthotic Supplier | 2617a Durham Chapel Hill Blvd, Durham, NC 27707 | 2009-05-27 |
| 1366641334 | Jerry M Wilch | Prosthetic/Orthotic Supplier | Box 3885 Dumc, M04 Davison Bldg, Durham, NC 27710-0001 | 2007-07-11 |
| 1750307161 | Nordstrom Inc & Subsidiaries | Prosthetic/Orthotic Supplier | 6910 Fayetteville Rd # 5000, Durham, NC 27713-9714 | 2006-07-15 |
| 1770589368 | Center for Orthotic and Prosthetic Care of North Carolina Inc | Prosthetic/Orthotic Supplier | Mo4 Davison Bldg, Dumc, Durham, NC 27710-0001 | 2005-06-28 |
| 1770121956 | Allure Me The Hair Estate | Prosthetic/Orthotic Supplier | 1910 Sedwick Rd, Durham, NC 27713-7807 | 2019-12-18 |
| 1760900146 | Center for Orthotic and Prosthetic Care of North Carolina Inc | Prosthetic/Orthotic Supplier | 3901 N Roxboro St Ste 112, Durham, NC 27704-2181 | 2017-09-06 |
| 1417402462 | Private Diagnostic Clinic, Pllc | Prosthetic/Orthotic Supplier | 4709 Creekstone Dr, Suite 300, Durham, NC 27703-9822 | 2016-08-19 |
| 1679916035 | Limbionics of Durham, Inc | Prosthetic/Orthotic Supplier | 5007 Southpark Dr, Suite 110, Durham, NC 27713-7739 | 2013-04-16 |
| Find all providers in DURHAM | ||||
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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.