CUSTOM HEALTHCARE, LLC (NPI# 1275583783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275583783 |
| Entity Type | Organization |
| Organization Name | CUSTOM HEALTHCARE, LLC |
| Other Organization Name | PPS ORTHOTIC & PROSTHETIC SERVICES |
| Practice Address |
3700 Brainerd Rd Chattanooga TN 37411-3603 |
| Practice Telephone | 4236970057 |
| Practice Fax Number | 4236489366 |
| Mailing Telephone | 4236970057 |
| Mailing Fax Number | 4236489366 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2020-03-20 |
| Authorized Official Name | MR. JAMES C ROGERS II (CEO) |
| Authorized Official Telephone | 4236970057 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 1036 | TN | Suppliers |
| N | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
1036 | TN | Suppliers |
| N | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
3347 | TN | Suppliers |
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000973794C | 05 | |
| MS | 05130009 | 05 | |
| TN | 1455062 | 05 | |
| KY | 7100162230 | 05 | |
| GA | 003113634A | 05 |
| Other Name | Type Code |
|---|---|
| PPS Orthotic & Prosthetic Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588122394 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 1101 Old Creek Rd Ste A1, Athens, GA 30607-1090 | 2019-03-11 |
| 1366900391 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 410 Dromedary St, Woodbury, GA 30293-3560 | 2019-03-08 |
| 1326511643 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 110 Palmetto Pkwy, Belton, SC 29627-2126 | 2019-01-09 |
| 1285109645 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 48 Morrison Ln, Ringgold, GA 30736-7277 | 2018-10-11 |
| 1083195663 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 902 12th St Ste B, Phenix City, AL 36867-5827 | 2018-08-22 |
| 1538437215 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 201 Center Park Dr Ste 1000, Knoxville, TN 37922-2105 | 2011-12-08 |
| 1770863532 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 806 Ulrich Ave, Louisville, KY 40219-1846 | 2011-08-25 |
| 1952451296 | Custom Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2150 N Ocoee St Ste C, Cleveland, TN 37311-3936 | 2007-01-11 |
| 1093017642 | Custom Healthcare, LLC | Prosthetic/Orthotic Supplier | 1508 N Thornton Ave, Ste 104, Dalton, GA 30720-8516 | 2010-12-01 |
| 1730481383 | Custom Healthcare, LLC | Prosthetic/Orthotic Supplier | 2400 E Andrew Johnson Hwy, Greeneville, TN 37745-0948 | 2010-12-01 |
| Street Address |
3700 BRAINERD RD |
| City | CHATTANOOGA |
| State | TN |
| Zip Code | 37411-3603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861497299 | Orthotic & Prosthetic Associates, Inc | Prosthetic/Orthotic Supplier | 3700 Brainerd Rd, Chattanooga, TN 37411-3603 | 2005-06-14 |
| 1174950349 | Jaime A Wirth | Orthotist | 3700 Brainerd Rd, Chattanooga, TN 37411-3603 | 2013-10-03 |
| 1740588193 | Eclipse Medical | Durable Medical Equipment & Medical Supplies | 3700 Brainerd Rd, Suites 34a 34b, Chattanooga, TN 37411-3603 | 2011-03-09 |
| 1467760462 | Penny J Carson | Specialist | 3700 Brainerd Rd, Chattanooga, TN 37411-3603 | 2010-09-24 |
| 1508174210 | John D Alexander | Specialist | 3700 Brainerd Rd, Chattanooga, TN 37411-3603 | 2010-09-15 |
| 1437464500 | Mary Elizabeth Bodine | Specialist | 3700 Brainerd Rd, Chattanooga, TN 37411-3603 | 2010-08-13 |
| 1588989354 | Melissa D Mcnew | Licensed Practical Nurse | 3700 Brainerd Rd, Chattanooga, TN 37411-3603 | 2010-04-05 |
| 1285963975 | Diversified Medical Solutions, LLC | Durable Medical Equipment & Medical Supplies | 3700 Brainerd Rd, Suite 100, Chattanooga, TN 37411-3603 | 2009-12-09 |
| 1245486844 | Christopher P Beardsley | Specialist | 3700 Brainerd Rd, Chattanooga, TN 37411-3603 | 2008-08-14 |
| 1134302011 | Claude Eric Harmon | Specialist | 3700 Brainerd Rd, Chattanooga, TN 37411-3603 | 2007-12-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811520620 | Winzetta Jenkins | Social Worker | 5705 Uptain Rd., Chattanooga, TN 37411 | 2020-02-20 |
| 1881156651 | Valerie L Radu | Social Worker | 5800 Uptain Road, Suite 1200, Chattanooga, TN 37411 | 2019-04-02 |
| 1568986693 | Solution Transportation Services, Inc | Non-emergency Medical Transport (VAN) | 4707 North Terrace, Chattanooga, TN 37411 | 2017-07-31 |
| 1689060733 | Nirlepkumar Patel | Pharmacist | 3602 Brainerd Road, Chattanooga, TN 37411 | 2015-04-15 |
| 1669896254 | Audra Valentaviciene | Nurse Practitioner | 5618 Brainerd Road, Chattanooga, TN 37411 | 2014-02-18 |
| 1376973198 | Kelly Leigh Kennedy | Nurse Practitioner | 5600 Brainerd Road, Suite B14, Chattanooga, TN 37411 | 2013-11-14 |
| 1417210071 | Jason Owen Blair | Physical Therapy Assistant | 5779 Brainard Rd, Chattanooga, TN 37411 | 2012-06-19 |
| 1447532270 | Masons and Daughter LLC | Non-emergency Medical Transport (VAN) | 7 North Tuxedo Ave, Chattanooga, TN 37411 | 2011-09-19 |
| 1841500386 | Pamela Denise Stultz | Physical Therapy Assistant | 3207 Rosemont Drive, Chattanooga, TN 37411 | 2010-10-18 |
| 1689803843 | Pauline Evans | Occupational Therapy Assistant | 1557 Pin Oak Dr, Chattanooga, TN 37411 | 2009-07-09 |
| Find all providers in zip 37411 | ||||
| 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 |
|---|---|---|---|---|
| 1437646171 | Amputee Solutions LLC | Prosthetic/Orthotic Supplier | 7401 E Brainerd Rd Ste 140, Chattanooga, TN 37421-3194 | 2018-04-18 |
| 1417451048 | The Plastic Surgery Group,pc | Prosthetic/Orthotic Supplier | 1949 Gunbarrel Rd Ste 303, Chattanooga, TN 37421-3188 | 2018-03-20 |
| 1336508431 | Ultraflex Systems, Inc. | Prosthetic/Orthotic Supplier | 200 W. Martin Luther King Blvd., Suite 1000, Chattanooga, TN 37402 | 2016-02-17 |
| 1669655999 | Dynamic Prosthetic & Orthotic, LLC | Prosthetic/Orthotic Supplier | 2116 Mccallie Ave, Chattanooga, TN 37404-3118 | 2007-12-10 |
| 1538357660 | P.s. Nails and Etc | Prosthetic/Orthotic Supplier | 480 Greenway View Dr, Suite 119, Chattanooga, TN 37411-5693 | 2007-10-15 |
| 1689891186 | Tara L Hewlett-bryant | Prosthetic/Orthotic Supplier | 557 N Willow St, Chattanooga, TN 37404-2233 | 2007-04-19 |
| 1225162548 | Center for Orthotic and Prosthetic Care of Ky, LLC | Prosthetic/Orthotic Supplier | 815 Brookhollow Ln, Chattanooga, TN 37421-4585 | 2007-03-16 |
| 1417055732 | Stubbs Prosthetics & Orthotics, Inc | Prosthetic/Orthotic Supplier | 5715 Uptain Rd Ste 5800, Chattanooga, TN 37411-5655 | 2006-09-20 |
| 1275571606 | Fillauer Orthotics and Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 2710 Amnicola Hwy, Chattanooga, TN 37406-3603 | 2006-06-04 |
| 1053395780 | Stubbs Prosthetics & Orthotics, Inc. | Prosthetic/Orthotic Supplier | 5715 Uptain Rd, Suite 5800, Chattanooga, TN 37411-5511 | 2005-12-06 |
| Find all providers in CHATTANOOGA | ||||
| City | CHATTANOOGA |
| Zip Code | 37411 |
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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.