COUNTRY COBBLER, LTD. (NPI# 1821344706) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821344706 |
| Entity Type | Organization |
| Organization Name | COUNTRY COBBLER, LTD. |
| Practice Address |
255 N Equity Dr Ste A Smithfield NC 27577-6054 |
| Practice Telephone | 9199896190 |
| Practice Fax Number | 9199896127 |
| Mailing Telephone | 9199896190 |
| Mailing Fax Number | 9199896127 |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2014-05-27 |
| Authorized Official Name | MR. MONTY K. MANTEY (PRESIDENT/OWNER) |
| 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 |
|---|---|---|---|---|
| 1255681797 | Country Cobbler, Ltd. | Prosthetic/Orthotic Supplier | 6815 Fayetteville Road, #102, Durham, NC 27713-7081 | 2012-09-12 |
| 1962758714 | Country Cobbler, Ltd. | Prosthetic/Orthotic Supplier | 1001 Airport Blvd, Suite 125, Morrisville, NC 27560-8935 | 2012-07-31 |
| 1780646653 | Country Cobbler, Ltd. | Prosthetic/Orthotic Supplier | 3501 Oleander Dr, Suite 11, Wilmington, NC 28403-0824 | 2006-04-05 |
| Street Address |
255 N EQUITY DR STE A |
| City | SMITHFIELD |
| State | NC |
| Zip Code | 27577-6054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851919047 | Sherwin Cuaresma Bernardino | Physical Therapist | Meadowview Assisted Living Center, 250 Nc-210, Smithfield, NC 27577 | 2020-07-14 |
| 1386297299 | Johnston Opco, LLC | Non-emergency Medical Transport (VAN) | 200 Kellie Dr, Smithfield, NC 27577 | 2019-07-19 |
| 1790255362 | Adrian Brook Taylor | Physical Therapist | 540 North Street, Smithfield, NC 27577 | 2018-11-27 |
| 1497260608 | Providence Healthcare of The Carolinas | Assisted Living Facility | 4302 Hwy Nc 210, Smithfield, NC 27577 | 2017-12-11 |
| 1720593908 | Latorya Delois Moore | Nurse Practitioner | 514 N Brightleaf Blvd Ste 1100, Smithfield, NC 27577 | 2017-12-09 |
| 1124546171 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 104 N Brightleaf Blvd, Smithfield, NC 27577 | 2017-08-30 |
| 1316482201 | Providence Pain, Spine & Recovery, Pllc | Anesthesiology | 7 Berkshire Rd, Smithfield, NC 27577 | 2016-12-30 |
| 1407203318 | Linda Pearl Trujillo | Early Intervention Provider Agency | 623 Tralee Dr, Smithfield, NC 27577 | 2016-05-20 |
| 1336500206 | Saundra Casey | Counselor | 15 Noble Street, Smithfield, NC 27577 | 2016-03-18 |
| 1639537707 | Ralph Edwin Wilson Jr. | Physician Assistant | 100 Kellie Drive, Smithfield, NC 27577 | 2016-02-04 |
| Find all providers in zip 27577 | ||||
| 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 |
|---|---|---|---|---|
| 1659970770 | Survivor Friendly LLC | Prosthetic/Orthotic Supplier | 527 Keisler Dr Ste 104, Cary, NC 27518-9306 | 2020-10-20 |
| 1154920395 | Anderson Prosthetics & Orthotics, LLC | Prosthetic/Orthotic Supplier | 307 W Tremont Ave Ste 200, Charlotte, NC 28203-4902 | 2020-10-20 |
| 1528666195 | Skyland Prosthetics & Orthotics Inc | Prosthetic/Orthotic Supplier | 1141 Tunnel Rd Ste E, Asheville, NC 28805-2037 | 2020-10-15 |
| 1982202545 | Davidson Prosthetics & Orthotics | Prosthetic/Orthotic Supplier | 845 Church St N Ste 205, Concord, NC 28025-4374 | 2020-10-15 |
| 1891301156 | Tys Cranial Prothesis | Prosthetic/Orthotic Supplier | 2400 S Memorial Dr Ste 3b, Greenville, NC 27834-5031 | 2020-09-21 |
| 1124645882 | The Royal Stich By Melinda | Prosthetic/Orthotic Supplier | 8032 Black Forest Ln Apt 10103, Charlotte, NC 28277-6746 | 2020-06-29 |
| 1073134573 | Diva Salon By Veronica Ashley, Inc. | Prosthetic/Orthotic Supplier | 10901 University City Blvd Ste 108, Charlotte, NC 28213-9300 | 2020-05-06 |
| 1841819711 | Sc&f Enterprises, LLC | Prosthetic/Orthotic Supplier | 2187 Skibo Rd, Fayetteville, NC 28314-0264 | 2020-04-10 |
| 1457986499 | Lala Lashes Charlotte | Prosthetic/Orthotic Supplier | 2434 Shad Ct, Charlotte, NC 28208-3307 | 2020-03-10 |
| 1871125237 | Elite Hair Replacement Inc | Prosthetic/Orthotic Supplier | 2110 Fort Bragg Rd Ste 112, Fayetteville, NC 28303-7036 | 2020-02-04 |
| Find all providers with the same taxonomy | ||||
| City | SMITHFIELD |
| Zip Code | 27577 |
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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.