BOODEN ORTHOPEDIC & PROSTHETIC CENTER INC (NPI# 1851631105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851631105 |
| Entity Type | Organization |
| Organization Name | BOODEN ORTHOPEDIC & PROSTHETIC CENTER INC |
| Practice Address |
5511 Princess Anne Rd Suite 101 Virginia Beach VA 23462-3321 |
| Mailing Address |
2418 Granby St Norfolk VA 23517-1422 |
| Practice Telephone | 7574908100 |
| Practice Fax Number | 7574908300 |
| Mailing Telephone | 7576274191 |
| Mailing Fax Number | 7576278709 |
| Enumeration Date | 2013-02-25 |
| Last Update Date | 2013-02-25 |
| Authorized Official Name | MR. JACK BOODEN (PRESIDENT) |
| Authorized Official Telephone | 7576274191 |
| Authorized Official Credential | CPO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 222Z00000X | Orthotist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 224P00000X | Prosthetist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 009190104 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | BOODEN ORTHOPEDIC & PROSTHETIC CENTER INC. | 2418 Granby St, Norfolk, Virginia 23517 |
| Street Address |
5511 PRINCESS ANNE RD SUITE 101 |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23462-3321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912534082 | Cheyenne James | Counselor | 297 Independence Blvd., Virginia Beach, VA 23462 | 2020-03-26 |
| 1245871011 | Marathon Transportation Services LLC | Non-emergency Medical Transport (VAN) | 4505 Main Street, Apt 259, Virginia Beach, VA 23462 | 2019-10-03 |
| 1003475153 | Keyuri S Shah | Physical Therapist | 5701 Cleveland St, Ste 600, Virginia Beach, VA 23462 | 2019-06-12 |
| 1629561329 | Mary Katherine Pratt | Physician Assistant | 828 Healthy Way Ste 350, Virginia Beach, VA 23462 | 2018-06-07 |
| 1801387808 | Matrixx Healthcare LLC | Respite Care | 405 S Parliament Dr Ste 106, Virginia Beach, VA 23462 | 2018-05-24 |
| 1518471671 | Newtown Chiropractic Center Pllc | Clinic/Center | 5777 Princess Ann Road, Virginia Beach, VA 23462 | 2017-11-28 |
| 1528587995 | Gary Lee Alexander II | Counselor | 870 N Newtown Road, Virginia Beach, VA 23462 | 2017-09-16 |
| 1801328810 | Servitium Med Va, LLC | Durable Medical Equipment & Medical Supplies | 4445 Corporation Lane Suite 291, Virginia Beach, VA 23462 | 2017-03-29 |
| 1215476171 | Johnnie Walter Cox IIi | Emergency Medical Technician, Basic | 5163 Cleveland Street, Virginia Beach, VA 23462 | 2017-02-13 |
| 1225570179 | Holly Balsamo | Occupational Therapy Assistant | 5345 Marian Lane, Virginia Beach, VA 23462 | 2016-11-09 |
| Find all providers in zip 23462 | ||||
| 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 |
|---|---|---|---|---|
| 1598313298 | Reach Orthotic & Prosthetic Service, Inc. | Prosthetic/Orthotic Supplier | 397 Little Neck Rd, Building 3400, Suite 107, Virginia Beach, VA 23452 | 2019-08-27 |
| 1437605003 | Coastal Prosthetics and Orthotics,llc | Prosthetic/Orthotic Supplier | 1924 Landstown Centre Way Ste 109, Box # 13 for Mail, Virginia Beach, VA 23456-1624 | 2016-09-01 |
| 1902176563 | Coastline Medical, Inc. | Prosthetic/Orthotic Supplier | 509 Viking Dr Ste E, Virginia Beach, VA 23452-7323 | 2012-01-12 |
| 1215260062 | Rehab Specialists, Inc. | Prosthetic/Orthotic Supplier | 2005 Harvest Moon Ct., Virginia Beach, VA 23453-6675 | 2009-09-11 |
| 1417130055 | Victoria Marie Graziano | Prosthetic/Orthotic Supplier | 277 N Lynnhaven Rd, Suite 108, Virginia Beach, VA 23452-6963 | 2007-12-05 |
| 1457551236 | Branne LLC | Prosthetic/Orthotic Supplier | 5262 Fairfield Shopping Ctr, Virginia Beach, VA 23464-4212 | 2007-07-20 |
| 1326069477 | Healthy Feet Inc | Prosthetic/Orthotic Supplier | 3500 Virginia Beach Blvd Ste 100, Virginia Beach, VA 23452-4445 | 2006-07-22 |
| 1508821117 | Montagnas Shoes Inc | Prosthetic/Orthotic Supplier | 752 Independence Blvd, Montagnas Shoes, Virginia Beach, VA 23455 | 2006-04-18 |
| 1124006713 | Progressive Prosthetic & Orthopedic Services, Inc. | Prosthetic/Orthotic Supplier | 380 Cleveland Pl, Virginia Beach, VA 23462-6529 | 2006-01-04 |
| 1386270643 | Coastal Prosthetics and Orthotics, LLC | Prosthetic/Orthotic Supplier | 1008 First Colonial Rd, Virginia Beach, VA 23454-3071 | 2020-03-19 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23462 |
Please comment or provide details below to improve the information on BOODEN ORTHOPEDIC & PROSTHETIC CENTER 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.