ACTIVE MOBILITY UPSTATE LLC (NPI# 1871780742) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871780742 |
| Entity Type | Organization |
| Organization Name | ACTIVE MOBILITY UPSTATE LLC |
| Other Organization Name | CAROLINA ORTHOTICS AND PROSTHETICS LLC |
| Practice Address |
115 Garner Road Spartanburg SC 29303 |
| Mailing Address |
3801 W. Montague Ave Suite 100 N Charleston SC 29418-5938 |
| Practice Telephone | 8645410028 |
| Practice Fax Number | 8645410027 |
| Mailing Telephone | 8435779577 |
| Mailing Fax Number | 8437181438 |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2017-06-26 |
| Authorized Official Name | MR. CLARENCE R HOOPER JR. (PRESIDENT) |
| Authorized Official Telephone | 8435779577 |
| Authorized Official Credential | CPO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | 042523929 | SC | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | DE3088 | 05 |
| Other Name | Type Code |
|---|---|
| Carolina Orthotics and Prosthetics LLC | Doing Business As Name - Organization |
| Street Address |
115 GARNER ROAD |
| City | SPARTANBURG |
| State | SC |
| Zip Code | 29303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013532126 | Adam Joseph Fulcher | Family Medicine | Center for Family Medicine, 853 N. Church Street, Suite 510, Spartanburg, SC 29303 | 2020-06-15 |
| 1275011652 | Tri-state Medical Supplies, North Grove | Durable Medical Equipment & Medical Supplies | 1330 Boiling Springs Rd Ste 2900, Spartanburg, SC 29303 | 2018-07-30 |
| 1992227151 | Roxanne Pope | Speech-Language Pathologist | 290 N Grove Medical Park Dr., Spartanburg, SC 29303 | 2017-07-10 |
| 1861934879 | Cortney Redmond Mckinney I | Counselor | 250 Dewey Sve., Spartanburg, SC 29303 | 2016-11-08 |
| 1578011474 | Instride Foot and Ankle Specialists, Pllc | Podiatrist | 269 North Grove Medical Drive, Spartanburg, SC 29303 | 2016-09-20 |
| 1023477536 | Whitney Brooke Terry | Physician Assistant | 391 Serpentine Dr Ste 250, Spartanburg, SC 29303 | 2016-02-12 |
| 1306244348 | Medcare Urgent Care Spartanburg, LLC | Clinic/Center | 301 E Wood Street, Spartanburg, SC 29303 | 2014-12-08 |
| 1508201393 | Tom Ju | Anesthesiology | 1330 Boiling Springs Rd Ste 2700, Spartanburg, SC 29303 | 2013-05-07 |
| 1295072312 | Marie O'dell | Registered Nurse | 7 698 Howard Street, Spartanburg School District, Spartanburg, SC 29303 | 2013-01-09 |
| 1518203330 | Sherard Hamilton Ansley | Speech-Language Pathologist | 698 Howard St., Spartanburg School District 7, Spartanburg, SC 29303 | 2012-12-26 |
| Find all providers in zip 29303 | ||||
| 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 |
|---|---|---|---|---|
| 1497374557 | Image Obsession LLC | Prosthetic/Orthotic Supplier | 1855 E Main St # Sr03, Spartanburg, SC 29307-2309 | 2020-04-09 |
| 1457858961 | Carolina Orthotics and Prosthetics LLC | Prosthetic/Orthotic Supplier | 115 Garner Rd, Spartanburg, SC 29303-3148 | 2018-04-11 |
| 1497113500 | Advanced Prosthetics of Spartanburg, LLC | Prosthetic/Orthotic Supplier | 790 N Church St, Spartanburg, SC 29303-3047 | 2016-02-03 |
| 1053625897 | Advanced Prosthetics of Spartanburg | Prosthetic/Orthotic Supplier | 102 Willow Ln, Spartanburg, SC 29307-1343 | 2010-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366056483 | C Marie Aesthetics | Prosthetic/Orthotic Supplier | 41f Goethe Rd, Bluffton, SC 29910-6001 | 2020-09-04 |
| 1124631056 | Dynesha Thomas | Prosthetic/Orthotic Supplier | 525 3rd Loop Rd Apt H, Florence, SC 29505-4706 | 2020-08-29 |
| 1427667591 | Ashleigha Rogers | Prosthetic/Orthotic Supplier | 324 Manning Ave, Sumter, SC 29150-5763 | 2020-07-24 |
| 1285252940 | Carolina Orthotics and Prosthetics LLC | Prosthetic/Orthotic Supplier | 708 Lafayette Ave, Ste 4, Camden, SC 29020 | 2020-07-09 |
| 1427676386 | Carolina Orthotics and Prosthetics LLC | Prosthetic/Orthotic Supplier | 1108 N Jefferies Blvd, Walterboro, SC 29488-2730 | 2020-07-08 |
| 1881219616 | Glammed Studio | Prosthetic/Orthotic Supplier | 47 Bristlecone Ln, Elgin, SC 29045-9584 | 2020-06-08 |
| 1598394926 | Hair Replacement Systems and Hairstyles Usa Inc. | Prosthetic/Orthotic Supplier | 105 E Butler Rd Ste C, Mauldin, SC 29662-2100 | 2020-04-07 |
| 1851958284 | Richard A Katenhusen | Prosthetic/Orthotic Supplier | 181 Bluffton Rd Ste B104, Bluffton, SC 29910-6218 | 2019-05-21 |
| 1699261917 | Carolina Bone & Joint Pa | Prosthetic/Orthotic Supplier | 1 Wellness Blvd Ste 104, Irmo, SC 29063-2872 | 2018-07-10 |
| 1598259954 | Natural Wigs Store | Prosthetic/Orthotic Supplier | 1722 Broad River Rd Ste C, Columbia, SC 29210-7336 | 2018-06-19 |
| Find all providers with the same taxonomy | ||||
| City | SPARTANBURG |
| Zip Code | 29303 |
Please comment or provide details below to improve the information on ACTIVE MOBILITY UPSTATE LLC.
| 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.