ORTHOTIC & PROSTHETIC SOLUTIONS LLC (NPI# 1962014100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962014100 |
| Entity Type | Organization |
| Organization Name | ORTHOTIC & PROSTHETIC SOLUTIONS LLC |
| Practice Address |
3670 Lakeland Ln # B-4 Jackson MS 39216-4700 |
| Mailing Address |
11616 Southfork Ave Ste 202 Baton Rouge LA 70816-5241 |
| Practice Telephone | 2253165444 |
| Practice Fax Number | 9852562599 |
| Mailing Telephone | 2253165444 |
| Mailing Fax Number | 9852562599 |
| Enumeration Date | 2020-08-19 |
| Last Update Date | 2020-08-27 |
| Authorized Official Name | DANDRE SHONDALE MOSTELLA (OWNER) |
| Authorized Official Telephone | 2564586071 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1744P3200X |
Specialist Specialization: Prosthetics Case Management |
Other Service Providers | ||
| 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 |
|---|---|---|---|
| MS | 1143 | 1143 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033746961 | Orthotic & Prosthetic Solutions LLC | Prosthetic/Orthotic Supplier | 11616 Southfork Ave Ste 202, Baton Rouge, LA 70816-5241 | 2020-03-23 |
| Street Address |
3670 LAKELAND LN # B-4 |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-4700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| 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 |
|---|---|---|---|---|
| 1962010645 | The Royal Studio | Prosthetic/Orthotic Supplier | 246 Briarwood Dr Ste 102, Jackson, MS 39206-3027 | 2020-07-17 |
| 1366064263 | Lavishinglux Hair Imports | Prosthetic/Orthotic Supplier | 200 Belle Chasse Cir, Jackson, MS 39212-3164 | 2020-05-13 |
| 1013563527 | State of Mississippi - University of Mississippi Medical Center | Prosthetic/Orthotic Supplier | 1410 E Woodrow Wilson Ave Ste I, Jackson, MS 39216-5114 | 2019-08-12 |
| 1306340476 | Anderson Brace & Limb Pllc | Prosthetic/Orthotic Supplier | 569 Skyline Dr Ste 201, Jackson, TN 38301-3933 | 2018-03-22 |
| 1134404932 | Human Technology, Inc. | Prosthetic/Orthotic Supplier | 2813 N. Highland Avenue, Jackson, TN 38305 | 2011-10-13 |
| 1225196801 | Biomedical Designs Inc. | Prosthetic/Orthotic Supplier | 306 W Washington Ave Ste 105, Jackson, MI 49201-2141 | 2006-12-05 |
| 1992870950 | Jackson Brace and Limb Company | Prosthetic/Orthotic Supplier | 1320 N State St, Jackson, MS 39202-2003 | 2006-11-22 |
| 1184718132 | Mid State Artificial Limb Co, Inc | Prosthetic/Orthotic Supplier | 4455 Medgar Evers Blvd, Jackson, MS 39213-5202 | 2006-10-03 |
| 1134147036 | Joy's Return | Prosthetic/Orthotic Supplier | 10350 Spunn Rd, Jackson, CA 95642-9509 | 2006-07-18 |
| 1083631931 | Orthotic Prosthetic Associates, Inc. | Prosthetic/Orthotic Supplier | 2105 West County Line Road, Suite 9, Jackson, NJ 08527 | 2006-07-16 |
| Find all providers in JACKSON | ||||
Please comment or provide details below to improve the information on ORTHOTIC & PROSTHETIC SOLUTIONS 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.