PREVAIL PROSTHETICS AND ORTHOTICS, INC (NPI# 1366583759) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366583759 |
| Entity Type | Organization |
| Organization Name | PREVAIL PROSTHETICS AND ORTHOTICS, INC |
| Practice Address |
7735 W Jefferson Blvd Suite C Fort Wayne IN 46804-4135 |
| Practice Telephone | 2604835219 |
| Practice Fax Number | 2604842291 |
| Mailing Telephone | 2604835219 |
| Mailing Fax Number | 2604842291 |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2018-11-29 |
| Authorized Official Name | CHRISTI HUDSON (BUSINESS MANAGER) |
| Authorized Official Telephone | 2604835219 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200405280 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396916888 | Prevail Prosthetics and Orthotics, Inc | Prosthetic/Orthotic Supplier | 3159 E Center Street Ext, Warsaw, IN 46582-3901 | 2008-03-12 |
| Street Address |
7735 W JEFFERSON BLVD SUITE C |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804-4135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871513614 | Larry Lee Libbee | Orthotist | 7735 W Jefferson Blvd, Suite C, Fort Wayne, IN 46804-4135 | 2006-07-21 |
| 1457892515 | Fred Toenges | Orthotist | 7735 W Jefferson Blvd, Suite C, Fort Wayne, IN 46804-4135 | 2017-03-09 |
| 1710998828 | Jennifer Jo Howard | Physician Assistant | 7735 W Jefferson Blvd, Fort Wayne, IN 46804-4135 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| Find all providers in zip 46804 | ||||
| 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 |
|---|---|---|---|---|
| 1184156101 | Shawn Dee Brown | Prosthetic/Orthotic Supplier | 2410 N Glendale Dr Ste C, Fort Wayne, IN 46804-8909 | 2017-03-29 |
| 1598215857 | Hafeezah Carter | Prosthetic/Orthotic Supplier | 2810 Maplecrest Rd, Fort Wayne, IN 46815-7016 | 2016-10-11 |
| 1104228394 | Transcend Orthotics & Prosthetics, LLC | Prosthetic/Orthotic Supplier | 417 Fernhill Ave, Fort Wayne, IN 46805-1039 | 2014-09-19 |
| 1861732935 | Maxcare Orthotics and Prosthetics LLC | Prosthetic/Orthotic Supplier | 3610 New Vision Dr, Fort Wayne, IN 46845-1706 | 2013-02-26 |
| 1720357965 | Maxcare Bionics Inc | Prosthetic/Orthotic Supplier | 2825 E Dupont Rd, Fort Wayne, IN 46825-1668 | 2011-12-16 |
| 1780855239 | Prevail Prosthetics and Orthotics | Prosthetic/Orthotic Supplier | 10826 Coldwater Rd., Fort Wayne, IN 46845-1241 | 2008-03-12 |
| 1427186436 | Legoras Conture Fashions | Prosthetic/Orthotic Supplier | 3316 Inwood Drive, Fort Wayne, IN 46815 | 2007-03-01 |
| 1891806402 | Fw Toenges & Sons Inc | Prosthetic/Orthotic Supplier | 3914 W. Jefferson Blvd., Fort Wayne, IN 46804-6812 | 2006-08-31 |
| 1205945847 | Barbara's New Beginnings,llc | Prosthetic/Orthotic Supplier | 4705 Illinois Rd Ste 113b, Fort Wayne, IN 46804-5108 | 2006-08-29 |
| 1073589081 | Ace Medical Supply, Inc | Prosthetic/Orthotic Supplier | 6155 Stoney Creek Dr, Fort Wayne, IN 46825-4409 | 2006-02-28 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46804 |
Please comment or provide details below to improve the information on PREVAIL PROSTHETICS AND ORTHOTICS, INC.
| 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.