DIXIE A. FULLERTON (NPI# 1609923242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609923242 |
| Entity Type | Organization |
| Organization Name | DIXIE A. FULLERTON |
| Other Organization Name | SUPERIOR LIMB & BRACE COMPANY |
| Practice Address |
1621 Fremont St Las Vegas NV 89101-5413 |
| Practice Telephone | 7023828287 |
| Practice Fax Number | 7023880727 |
| Mailing Telephone | 7023828287 |
| Mailing Fax Number | 7023880727 |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2012-07-23 |
| Authorized Official Name | MRS. DIXIE A FULLERTON (OWNER) |
| Authorized Official Telephone | 7023828287 |
| 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 |
|---|---|---|---|
| NV | 003302875 | 05 |
| Other Name | Type Code |
|---|---|
| Superior Limb & Brace Company | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336296979 | Dixie A. Fullerton | Prosthetic/Orthotic Supplier | 1618 E Charleston Blvd, Las Vegas, NV 89104-1826 | 2007-01-05 |
| Street Address |
1621 FREMONT ST |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89101-5413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225671290 | Nadhc At The Acsc, Inc. | Respite Care | 330 N. 13th Street, Las Vegas, NV 89101 | 2019-10-23 |
| 1861033730 | Militza Mares Mikovich | Case Manager/Care Coordinator | 820 S 7th Street Ste A, Las Vegas, NV 89101 | 2019-10-02 |
| 1598311862 | Catalina Ruiz-perez | Technician | 1420 James St., L, Las Vegas, NV 89101 | 2019-08-13 |
| 1053880831 | Samantha Okumura | Specialist/Technologist | 701 E Bridger Ave Ste 150, Las Vegas, NV 89101 | 2018-11-21 |
| 1447752860 | Ratref T Havlin | Technician | 1820 East Bonanza Apt 1, Las Veges, NV 89101 | 2018-03-01 |
| 1396255808 | David Markus Stevens | Technician/Technologist | 930 N. 4th Street, Las Vegas, NV 89101 | 2017-10-10 |
| 1447789888 | Dustin Douglas | Driver | 50 N 21 St #139, Las Vegas, NV 89101 | 2017-06-08 |
| 1013389535 | Direct Scripts Mail, LLC | Pharmacy | 71 N Pecos Road, Suite 104, Las Vegas, NV 89101 | 2015-10-23 |
| 1699169920 | Westcare Nevada Inc | Community/Behavioral Health | 323 N Maryland Parkway, Las Vegas, NV 89101 | 2015-03-25 |
| 1639574262 | Misty Davis | Registered Nurse | 930 N. 4th St., Las Vegas, NV 89101 | 2014-10-24 |
| Find all providers in zip 89101 | ||||
| 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 |
|---|---|---|---|---|
| 1912362245 | Back In Step | Prosthetic/Orthotic Supplier | 2820 W Charleston Blvd Ste 32, Las Vegas, NV 89102-1934 | 2015-12-31 |
| 1497148886 | Dentistry 4 Sleep Apnea LLC | Prosthetic/Orthotic Supplier | 6960 Westcliff Dr Ste 200, Las Vegas, NV 89145-4201 | 2015-03-10 |
| 1093153264 | Beauty Venom Hair Loss Center | Prosthetic/Orthotic Supplier | 7785 N Durango Dr, Suite 125, Las Vegas, NV 89131-8000 | 2013-06-11 |
| 1144551292 | Orthopedic Motion Inc | Prosthetic/Orthotic Supplier | 8920 W Sunset Rd, Las Vegas, NV 89123 | 2010-01-28 |
| 1316181605 | Orthopedic Motion Inc | Prosthetic/Orthotic Supplier | 8402 Centennial Pkwy, Las Vegas, NV 89149-4726 | 2009-04-30 |
| 1295999811 | Christine Frances Ledoux | Prosthetic/Orthotic Supplier | 4680 S Eastern Ave Ste H, Las Vegas, NV 89119-6192 | 2008-07-13 |
| 1013182666 | Therapeutic Massaging Insoles | Prosthetic/Orthotic Supplier | 3280 Wynn Rd, Suite #1, Las Vegas, NV 89102-7823 | 2008-04-24 |
| 1215135447 | Orthopedic Motion Inc. | Prosthetic/Orthotic Supplier | 1525 E Windmill Ln., Las Vegas, NV 89123 | 2007-07-10 |
| 1336296979 | Dixie A. Fullerton | Prosthetic/Orthotic Supplier | 1618 E Charleston Blvd, Las Vegas, NV 89104-1826 | 2007-01-05 |
| 1508882960 | Nordstrom Inc & Subsidiaries | Prosthetic/Orthotic Supplier | 3200 Las Vegas Blvd S Ste 710, Las Vegas, NV 89109-2675 | 2006-07-15 |
| Find all providers in LAS VEGAS | ||||
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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.