CUSTOM ORTHOTICS OF NORTH CAROLINA, LLC (NPI# 1932127396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932127396 |
| Entity Type | Organization |
| Organization Name | CUSTOM ORTHOTICS OF NORTH CAROLINA, LLC |
| Practice Address |
4125 Ben Franklin Blvd Suite 180 Durham NC 27704-2167 |
| Practice Telephone | 9194795990 |
| Practice Fax Number | 9194798782 |
| Mailing Telephone | 9194795990 |
| Mailing Fax Number | 9194798782 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. STEPHEN BRADLEY DEAL (OPERATIONS MANAGER, ORTHOTIST) |
| Authorized Official Telephone | 9194795990 |
| Authorized Official Credential | BO, CO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
C18399 | NC | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS PROVIDER NUMBER | 046P3 | 01 |
| NC | 7704266 | 05 |
| Street Address |
4125 BEN FRANKLIN BLVD SUITE 180 |
| City | DURHAM |
| State | NC |
| Zip Code | 27704-2167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861463408 | Sandra Jean Preissler | Social Worker | 4125 Ben Franklin Blvd, Suite 160, Durham, NC 27704-2167 | 2006-01-31 |
| 1326478058 | Waverly Rachel Harrell | Psychologist | 4125 Ben Franklin Blvd, Suite 160, Durham, NC 27704-2167 | 2013-11-15 |
| 1871815449 | Janis Davis | Counselor | 4125 Ben Franklin Blvd, Durham, NC 27704-2167 | 2010-02-23 |
| 1730412727 | Joi Lashawn Edwards | Physical Therapist | 4125 Ben Franklin Blvd, Durham, NC 27704-2167 | 2009-09-09 |
| 1649420837 | Toya Mari Hart | Specialist | 4125 Ben Franklin Blvd, Suite 180, Durham, NC 27704-2167 | 2008-09-24 |
| 1376703546 | Michael Martin Butler | Psychologist | 4125 Ben Franklin Blvd, Suite 160, Durham, NC 27704-2167 | 2008-06-11 |
| 1316116692 | Kjersten Ernooth Marlow | Specialist | 4125 Ben Franklin Blvd, Suite 140, Durham, NC 27704-2167 | 2008-02-21 |
| 1336337062 | Wright Orthopedic Sports Medicine and Fitness Institute Pa | Orthopaedic Surgery | 4125 Ben Franklin Blvd, Suite 140, Durham, NC 27704-2167 | 2007-10-09 |
| 1104901511 | Julie Catherine Lee | Psychologist | 4125 Ben Franklin Blvd, Suite 160, Durham, NC 27704-2167 | 2006-10-25 |
| 1164532271 | Mark A Ginsberg | Psychologist | 4125 Ben Franklin Blvd, Suite 160, Durham, NC 27704-2167 | 2006-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245723139 | Devang Ashokbhai Patel | Dentist | 2609 N Duke St Ste 618, Durham, NC 27704 | 2018-06-14 |
| 1891201042 | Little Family Care Home, LLC | Custodial Care Facility | 1012 Davinci Street, Durham, NC 27704 | 2017-12-26 |
| 1033625702 | Tondra A Little | Social Worker | 2804 Nellowood Street, Durham, NC 27704 | 2017-12-18 |
| 1437502408 | Jhazmere Shamas Preston | Counselor | 2609 N. Duke St. Suite 403, Durham, NC 27704 | 2016-07-14 |
| 1649626656 | Professional Elevations Pllc | Case Manager/Care Coordinator | 304 Crutchfield Drive, Durham, NC 27704 | 2016-05-09 |
| 1083071617 | Alyssa Wilson | Speech-Language Pathologist | 215 William Penn Plz Apt 908, Durham, NC 27704 | 2016-01-27 |
| 1932565124 | Arthur Reynolds Jr and Associates P.l.l.c. | Dentist | 2106 N Duke St, Durham, NC 27704 | 2016-01-05 |
| 1962877720 | Chimere Brooks | Contractor | 4001meriwether Drive Apt P-19, Durham, NC 27704 | 2015-12-04 |
| 1184013294 | Danielle King | Physician Assistant | 3611 N Duke Street, Durham, NC 27704 | 2015-01-13 |
| 1730581901 | Images, 'of Me To You' | Community/Behavioral Health | 2823 Cascadilla Street, Durham, NC 27704 | 2014-09-19 |
| Find all providers in zip 27704 | ||||
| Taxonomy Code | 332BC3200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Customized Equipment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952475832 | Hanger Prosthetics & Orthotics East Inc | Durable Medical Equipment & Medical Supplies | 3901 N Roxboro St Ste 112, Durham, NC 27704-2181 | 2006-11-20 |
| 1316937980 | Healthcare Equipment, Inc. | Durable Medical Equipment & Medical Supplies | 4228 Garrett Rd, Durham, NC 27707-3430 | 2005-10-25 |
| 1295934198 | Triangle Lifeline | Durable Medical Equipment & Medical Supplies | 3414 N Duke St, Suite 400, Durham, NC 27704-2131 | 2007-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972102051 | Sassy Stylez | Durable Medical Equipment & Medical Supplies | 231 Graham Meadow Dr, Charlotte, NC 28213-4921 | 2020-10-20 |
| 1093327736 | Mcduffie & Associates, Inc | Durable Medical Equipment & Medical Supplies | 203 Church Hill Ct, New Bern, NC 28562-4870 | 2020-08-22 |
| 1003426388 | Bradley Cecil | Durable Medical Equipment & Medical Supplies | 50 E Main St Ste 100, Thomasville, NC 27360-4000 | 2020-08-03 |
| 1366067035 | Carolina Hair Loss & Prosthetics | Durable Medical Equipment & Medical Supplies | 1903 N Pine St, Lumberton, NC 28358-3969 | 2020-06-09 |
| 1275189540 | Et Care Inc | Durable Medical Equipment & Medical Supplies | 500 E Gannon Ave, Zebulon, NC 27597-2776 | 2019-08-13 |
| 1821656976 | Ashley S Desaix Dds Pa | Durable Medical Equipment & Medical Supplies | 3420 Ten Ten Rd Ste 310, Cary, NC 27518-6101 | 2019-06-04 |
| 1790349850 | Unique Boutique Inc | Durable Medical Equipment & Medical Supplies | 200 Medical Park Dr Ste 145, Concord, NC 28025-0928 | 2019-04-24 |
| 1447719810 | National Seating & Mobility, Inc. | Durable Medical Equipment & Medical Supplies | 8421 Old Statesville Rd Ste 18, Charlotte, NC 28269-1838 | 2019-03-15 |
| 1821569294 | Atlantic Coast Orthopedic Medical Supplies | Durable Medical Equipment & Medical Supplies | 6510 Northpark Blvd Ste A, Charlotte, NC 28216-2367 | 2018-12-11 |
| 1215444195 | Monica Lilly | Durable Medical Equipment & Medical Supplies | 123 N Main St Ste A, Norwood, NC 28128-9603 | 2018-01-02 |
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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.