NORTHWEST ORTHOTICS & PROSTHETICS (NPI# 1912991738) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912991738 |
| Entity Type | Organization |
| Organization Name | NORTHWEST ORTHOTICS & PROSTHETICS |
| Practice Address |
1675 N Freedom Blvd Ste 12 C Provo UT 84604-2540 |
| Practice Telephone | 8013773433 |
| Practice Fax Number | 8013774127 |
| Mailing Telephone | 8013773433 |
| Mailing Fax Number | 8013774127 |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2013-05-09 |
| Authorized Official Name | DAVID HILL (OWNER / BOCO) |
| Authorized Official Telephone | 8013773433 |
| Authorized Official Credential | BOCO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
D44206 | UT | Suppliers |
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 820305315003 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114306891 | Northwest Orthotics & Prosthetics | Prosthetic/Orthotic Supplier | 642 Kirby Ln Ste 103, Spanish Fork, UT 84660-5753 | 2015-05-27 |
| 1295979649 | Northwest Orthotics & Prosthetics | Prosthetic/Orthotic Supplier | 1988 W 930 N, Ste C, Pleasant Grove, UT 84062-4131 | 2009-04-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NORTHWEST ORTHOTICS & PROSTHETICS | 1675 N 200 W Ste 12c, Provo, UT 84604-6940 |
| Street Address |
1675 N FREEDOM BLVD STE 12 C |
| City | PROVO |
| State | UT |
| Zip Code | 84604-2540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942588082 | Keith J. Clayton, M.d., P.C. | Pediatrics | 1675 N Freedom Blvd, Ste 9c, Provo, UT 84604 | 2011-07-22 |
| 1851693808 | Russell James Bailey | Psychologist | 1675 N Freedom Blvd, Suite 2b2, Provo, UT 84604-2540 | 2010-11-24 |
| 1174778450 | Matthew Joseph Clayton | Pediatrics | 1675 N Freedom Blvd, Ste 9c, Provo, UT 84604-2540 | 2008-11-30 |
| 1932353539 | Now I Can Foundation | Clinic/Center | 1675 N Freedom Blvd, Suite 10b, Provo, UT 84604-2540 | 2008-11-10 |
| 1639321540 | Elizabeth Ann Jensen | Physical Therapist | 1675 N Freedom Blvd, Building 10b, Provo, UT 84604-2540 | 2008-10-22 |
| 1336364629 | Darren Wesley Gardner | Dentist | 1675 N Freedom Blvd, Ste 12a, Provo, UT 84604-2540 | 2007-04-13 |
| 1184847063 | New Horizon Women's Care, LLC | Internal Medicine | 1675 N Freedom Blvd, Suite 3, Provo, UT 84604-2540 | 2007-04-10 |
| 1336219906 | Kent Blad | Nurse Practitioner | 1675 N Freedom Blvd, Bldg 3, Provo, UT 84604-2540 | 2006-11-09 |
| 1194824201 | Provo Dialysis Center University of Utah | Clinic/Center | 1675 N Freedom Blvd, Provo, UT 84604-2540 | 2006-09-22 |
| 1265452163 | Damon Monson Faust | Chiropractor | 1675 N Freedom Blvd, 7a, Provo, UT 84604-2540 | 2006-07-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346882107 | Abigail Belle Hardy | Student in an Organized Health Care Education/Training Program | 1190 900 E, Provo, UT 84604 | 2019-10-14 |
| 1386106698 | Sarah Roseman Hunt | Nurse Practitioner | 1055 N 500 W., Suite. 101, Bldg. C, Provo, UT 84604 | 2019-04-04 |
| 1255813325 | Hwigeum Jeong | Specialist/Technologist | Department of Exercise Sciences 106 Sfh Brigham Young, Provo, UT 84604 | 2018-09-05 |
| 1093203044 | Snowcap Smile Studio LLC | Dentist | 2230 N. University Pkwy Ste 8b, Provo, UT 84604 | 2018-04-25 |
| 1407359078 | Ihc Health Services Inc | Clinic/Center | 380 W Bulldog Blvd, Ste 403, Provo, UT 84604 | 2018-03-09 |
| 1902308455 | Afton Leuga | Nurse Practitioner | 395 W Bulldog Blvd., Suite 401, Provo, UT 84604 | 2018-03-01 |
| 1851807333 | Ihc Health Services Inc | Family Medicine | 380 W 1230 N, Ste 602, Provo, UT 84604 | 2017-12-20 |
| 1689180218 | Ihc Health Services Inc | Pediatrics | 395 W Bulldog Blvd Ste 703, Provo, UT 84604 | 2017-12-19 |
| 1396254165 | Nicolas Sorensen | Massage Therapist | 247 West 2230 North #201, Provo, UT 84604 | 2017-09-25 |
| 1437692241 | Cirque Lodge Inc | Substance Abuse Rehabilitation Facility | 3114 E Ida's Road, Sundance, UT 84604 | 2016-11-28 |
| Find all providers in zip 84604 | ||||
| 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 |
|---|---|---|---|---|
| 1245484906 | Diabetes Specialty Center LLC | Prosthetic/Orthotic Supplier | 1254 N State St, Provo, UT 84604-6432 | 2008-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578035713 | Feminine Forms LLC | Prosthetic/Orthotic Supplier | 345 S 500 E, American Fork, UT 84003-2525 | 2018-12-28 |
| 1841761095 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 4225 W Lake Park Blvd Ste 225, West Valley City, UT 84120-8213 | 2018-12-16 |
| 1114441441 | Asd Sleep LLC | Prosthetic/Orthotic Supplier | 1957 W Royal Hunte Dr, #250, Cedar City, UT 84720 | 2017-07-28 |
| 1992226302 | Freedom Prosthetic & Orthotics, LLC | Prosthetic/Orthotic Supplier | 356 E 600 S, St George, UT 84770-3949 | 2017-07-06 |
| 1356792634 | Fit Prosthetics LLC | Prosthetic/Orthotic Supplier | 154 E Myrtle Ave, Suite #100, Murray, UT 84107-4849 | 2016-06-28 |
| 1750760369 | Women Restore LLC | Prosthetic/Orthotic Supplier | 1171 Expressway Ln, Spanish Fork, UT 84660-1331 | 2015-05-28 |
| 1114306891 | Northwest Orthotics & Prosthetics | Prosthetic/Orthotic Supplier | 642 Kirby Ln Ste 103, Spanish Fork, UT 84660-5753 | 2015-05-27 |
| 1457752503 | Eaze Bracing | Prosthetic/Orthotic Supplier | 1324 W 7125 S, West Jordan, UT 84084 | 2014-09-09 |
| 1851686588 | Walking Comfort LLC. | Prosthetic/Orthotic Supplier | 627 W. Marketplace Dr., Centerville, UT 84014-0000 | 2011-06-10 |
| 1205155777 | Jenco Prosthetics & Orthotics, LLC | Prosthetic/Orthotic Supplier | 7026 South Commerce Park Dr, Suite 2, Midvale, UT 84047-1026 | 2010-05-24 |
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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.