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THE CUSTOM SOURCE INC
NPI 1114902665
Prosthetic/Orthotic Supplier in Matthews, NC

Active since December 07, 2005
1013 CHESTNUT LN STE 120, MATTHEWS, NC 28104(704) 893-5457(704) 973-0696 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Jun 7, 2017 (2 updates tracked since 2017).

About The Custom Source Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THE CUSTOM SOURCE INC (NPI 1114902665) is a healthcare organization registered as a prosthetic/orthotic supplier in Matthews, North Carolina and active in the NPI registry since December 2005. The organization lists Kasey Rolfes, Operations Manager, as its authorized official.

NPPES Registry Identity

NPI1114902665
Entity TypeOrganization
Primary Taxonomy335E00000X
Legal Business NameTHE CUSTOM SOURCE INC
Location Address1013 CHESTNUT LN STE 120Matthews, NC 28104-8567
Mailing Address1013 Chestnut Ln Ste 120Matthews, NC 28104-8567 · (704) 893-5457 · Fax (704) 973-0696
Phone(704) 893-5457
Fax(704) 973-0696
Organization SubpartNo
Authorized OfficialKasey RolfesOperations Manager · (704) 893-5457
Enumeration DateDecember 7, 2005
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1114902665 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyProsthetic/Orthotic SupplierSuppliers
Taxonomy Code335E00000X
Definition
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.
Also ListedOrthotistTaxonomy 222Z00000X
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
1013 CHESTNUT LN STE 120, Matthews, NC 28104
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Other Identifiers 2

Medicaid7700578NC
Other0491EBc/bs/nc

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. THOMAS J MORGAN MS, LAT,ATC,PES,EMT
Specialist/Technologist (Athletic Trainer)
1013 CHESTNUT LN STE 120
MATTHEWS, NC 28104
Union County (704) 893-5487

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is The Custom Source Inc's NPI number?

The NPI number for The Custom Source Inc is 1114902665. It was assigned to this organization in the NPPES registry on December 7, 2005.

Where is The Custom Source Inc located?

The Custom Source Inc is located at 1013 Chestnut Ln Ste 120, Matthews, NC 28104. The listed phone number is (704) 893-5457.

What is The Custom Source Inc's specialty?

The primary specialty registered for this NPI is Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.

When was this NPI record last updated?

The NPPES record for The Custom Source Inc was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.