Provider Type Icon

CENTER FOR ORTHOTIC & PROSTHETIC EXCELLENCE LLC NPI 1346424728


NPI Information

NPI: 1346424728
Provider Name: CENTER FOR ORTHOTIC & PROSTHETIC EXCELLENCE, LLC
Classification: Prosthetic/Orthotic Supplier - 335E00000X
Entity Type: Organization
Address:
9615 KEILMAN ST
SUITE 200
SAINT JOHN, IN
ZIP 46373
Phone: (219) 365-0248
Get Directions

CENTER FOR ORTHOTIC & PROSTHETIC EXCELLENCE, LLC is a prosthetic orthotic supplier in Saint John, IN. The provider is 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. CENTER FOR ORTHOTIC & PROSTHETIC EXCELLENCE, LLC NPI is 1346424728. The provider is registered as an organization entity type.

The provider's business location address is:

9615 KEILMAN ST
SUITE 200
SAINT JOHN, IN
ZIP 46373
Phone: (219) 365-0248
Fax: (219) 365-0072

The provider's authorized official is Donald Goertzen .
The authorized official title is President and has the following contact phone number (309) 676-2276.

The enumeration date for this NPI number is 12/20/2007 and was last updated on 7/30/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1335E00000XProsthetic/Orthotic SupplierINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1213.000102OTHERILLINOISSTATE OF ILLINOIS - LICENSED ORTHOTIST
2CO003904OTHERINDIANAAMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS & PROSTHETICS
3=========-001MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.