1457310492 NPI number — ORTHODYNAMICS COMPANY, INC.

Table of content: (NPI 1457310492)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457310492 NPI number — ORTHODYNAMICS COMPANY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORTHODYNAMICS COMPANY, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457310492
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/14/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
155 CAREY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NOBLESVILLE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46060-1302
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-497-9107
Provider Business Mailing Address Fax Number:
317-774-0146

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
155 CAREY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NOBLESVILLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46060-1302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-497-9107
Provider Business Practice Location Address Fax Number:
317-774-0146
Provider Enumeration Date:
03/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GIGANTE
Authorized Official First Name:
ANDREW
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PRESIDENT & CEO
Authorized Official Telephone Number:
800-497-9107

Provider Taxonomy Codes

  • Taxonomy code: 293D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X , with the licence number: 0007066856 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332BC3200X , with the licence number: 0007066856 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335E00000X , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3938596 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1023695 . This is a "ACM PROVIDER NUMBER" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 250693328 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 403296301 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: IN4658 . This is a "IDTF PTAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 258225200 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 500823909 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".
  • Identifier: IN1859 . This is a "HEALTHNET PROVIDER NUMBER" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 0005562645 . This is a "AETNA PROVIDER NUMBER" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 108958400 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 232960 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 300015837 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4115233 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 90012212 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: ACS129561000 . This is a "US DOL PROVIDER NUMBER" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 000000097460 . This is a "ANTHEM PROVIDER NUMBER" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 102394927 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1457310492 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0639486 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1457310492 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".




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