DESERT PROSTHETIC & ORTHOTIC REHABILITATION (NPI# 1962699504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962699504 |
| Entity Type | Organization |
| Organization Name | DESERT PROSTHETIC & ORTHOTIC REHABILITATION |
| Practice Address |
4915 E. Baseline Road Suite 109 Gilbert AZ 85234 |
| Mailing Address |
4915 E. Baseline Rd. Suite 109 Gilbert AZ 85234 |
| Practice Telephone | 4804979929 |
| Practice Fax Number | 4804979928 |
| Mailing Telephone | 4804979929 |
| Mailing Fax Number | 4804979928 |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2010-02-22 |
| Authorized Official Name | JERRY AUTRY (OWNER) |
| Authorized Official Telephone | 4804979929 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| Street Address |
4915 E. BASELINE ROAD SUITE 109 |
| City | GILBERT |
| State | AZ |
| Zip Code | 85234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629050158 | Samantha T. Kolinski | Dentist | 4915 E. Baseline Road, Suite 107, Gilbert, AZ 85234 | 2005-11-18 |
| 1366671059 | Gateway Dentistry, Pllc | Dentist | 4915 E. Baseline Road, Suite 107, Gilbert, AZ 85234 | 2009-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710500962 | Fatima Health LLC | Nurse Practitioner | 760 North Swallow Lane, Gilbert, AZ 85234 | 2020-05-22 |
| 1073152070 | American Care Concepts Hospice LLC | Hospice Care, Community Based | 765 N. Lindsay Rd., Ste. 208, Gilbert, AZ 85234 | 2019-12-23 |
| 1457918864 | Intuitive Healing Counseling Services, Pllc | Counselor | 3303 E Baseline Rd, Building 5, Suite 109, Gilbert, AZ 85234 | 2019-05-21 |
| 1487123907 | San Tan Behavioral Health Services LLC | Respite Care | 2671 East Vermont Court, Gilbert, AZ 85234 | 2018-11-14 |
| 1770052292 | San Tan Behavioral Health Services | Respite Care | 3970 East Juanita Avenue, Gilbert, AZ 85234 | 2018-11-14 |
| 1891262887 | Victoria Elizabeth Klennertt | Behavior Technician | 3503 E Michelle Way, Gilbert, AZ 85234 | 2018-10-27 |
| 1225503634 | Julia Elizabeth Wiens | Social Worker | 3651 E Baseline Rd Ste 120, Gilbert, AZ 85234 | 2018-10-11 |
| 1295219798 | Raylene Dawn Cargiulo | Registered Nurse | 55 S. Greenfield Rd., Gilbert, AZ 85234 | 2018-09-20 |
| 1346729092 | Katherine M Winegar | Nurse Practitioner | Banner Md Anderson Cancer Center- Administration Office, 2940 E Banner Gateway Drive, Gilbert, AZ 85234 | 2018-08-13 |
| 1881189199 | Desert Valley Oral Surgery | Oral & Maxillofacial Surgery | 2915 E. Baseline Road, Suite 106, Gilbert, AZ 85234 | 2018-06-28 |
| Find all providers in zip 85234 | ||||
| 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 |
|---|---|---|---|---|
| 1851916217 | Bionic Prosthetics and Orthotics Group LLC | Prosthetic/Orthotic Supplier | 633 E Ray Rd Ste 111, Gilbert, AZ 85296-4202 | 2020-06-11 |
| 1952580763 | Valley Orthotics and Prosthetics Inc. | Prosthetic/Orthotic Supplier | 4915 E Baseline Rd, Suite 109, Gilbert, AZ 85234-2965 | 2007-10-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285258996 | Mobility Prosthetic and Orthotic Services LLC | Prosthetic/Orthotic Supplier | 1921 Motor Ave Ste B, Kingman, AZ 86401-4185 | 2020-05-29 |
| 1083254528 | Active Life Orthotics and Prosthetics Corp | Prosthetic/Orthotic Supplier | 3811 E Bell Rd Ste 112, Phoenix, AZ 85032-2158 | 2020-01-13 |
| 1487291688 | Nevada Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 1863 Airfied Avenue, Kingman, AZ 86401-4004 | 2019-12-06 |
| 1841857596 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 7330 N 99th Ave Ste 225, Glendale, AZ 85307-3003 | 2019-05-28 |
| 1992362370 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 6373 E Tanque Verde Rd Ste 140, Tucson, AZ 85715-3835 | 2019-05-21 |
| 1629539275 | Capitol Orthopedic Inc | Prosthetic/Orthotic Supplier | 4001 N 3rd St Ste 405, Phoenix, AZ 85012-2065 | 2019-03-27 |
| 1245724822 | Medsource Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 1450 S Dobson Rd Ste B326, Mesa, AZ 85202 | 2018-06-18 |
| 1184133191 | Lumin Enterprises | Prosthetic/Orthotic Supplier | 15207 N 75th St Ste 111, Scottsdale, AZ 85260-2445 | 2017-09-21 |
| 1942727250 | Ideal Health Care, L.L.C. | Prosthetic/Orthotic Supplier | 1675 Mesquite Ave Ste A, Lake Havasu City, AZ 86403 | 2017-08-28 |
| 1548787930 | Limb Center LLC | Prosthetic/Orthotic Supplier | 3020 N 44th St, Phoenix, AZ 85018-7206 | 2017-08-25 |
| Find all providers with the same taxonomy | ||||
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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.