SOUTHEASTERN ORTHOTICS & PROSTHETICS, INC
NPI 1679572655
Prosthetic/Orthotic Supplier in Chattanooga, TN
NPI Status: Active since July 20, 2005
Contact Information
316 N HOLTZCLAW AVE
CHATTANOOGA, TN
ZIP 37404
Phone: (423) 698-0184
Fax: (423) 698-0568
- Organization
- Prosthetic/Orthotic Supplier
- Accepts Insurance
- Medicare Supplier
- Does Not Accept Medicare Approved Payment
- CLIA Number: 44D2053806
- CLIA Cert. Type: Other - CLINICAL RESEARCH OFFICE
- CLIA Exp. Date: 02-06-2027
About SOUTHEASTERN ORTHOTICS & PROSTHETICS, INC
This page provides the complete NPI Profile along with additional information for Southeastern Orthotics & Prosthetics, Inc, a provider established in Chattanooga, Tennessee operating as a Prosthetic/orthotic Supplier. The healthcare provider is registered in the NPI registry with number 1679572655 assigned on July 2005. The practitioner's primary taxonomy code is 335E00000X. The provider is registered as an organization and their NPI record was last updated April 2026. Southeastern Orthotics & Prosthetics, Inc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's
- NPI
- 1679572655
- Provider Legal Name
- SOUTHEASTERN ORTHOTICS & PROSTHETICS, INC
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 316 N HOLTZCLAW AVE CHATTANOOGA, TN 37404
- Location Phone
- (423) 698-0184
- Location Fax
- (423) 698-0568
- Mailing Address
- 316 N HOLTZCLAW AVE CHATTANOOGA, TN 37404
- Mailing Phone
- (423) 698-0184
- Mailing Fax
- (423) 698-0568
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-20-2005
- Last Update Date
- 04-07-2026
- Code Navigator
Southeastern Orthotics & Prosthetics, Inc is a medicare supplier with PTAN 20639051 who does not accept Medicare assignment for all durable medical equipment and supplies. The provider may not accept the Medicare allowable as payment in full and may collect additional payment directly from the patient, and/or charge more than the Medicare allowable.The supplier carries the following product categories: Orthoses: Custom Fabricated or Orthoses: Prefabricated (Non-Custom Fabricated) or Orthoses: Off-The-Shelf or Limb Prostheses or Diabetic Shoes and Inserts or Diabetic Shoes/Inserts - Custom or Lymphedema Compression Treatment Items.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Prosthetic/Orthotic Supplier
- Taxonomy Code
- 335E00000X
- Type
- Suppliers
- License State
- TN
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 224P00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Prosthetist |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- SoloCare Bronze EPO $8500 DED HSA 10004 - EPO
- SoloCare Exp Bronze EPO $9500 DED 10015 - EPO
- SoloCare Gold EPO $1500 DED 10010 - EPO
- SoloCare Silver EPO $5000 DED 10014 - EPO
- SoloCare Silver EPO $6500 DED 10013 - EPO
- SoloCare Standard Exp Bronze EPO $7500 DED 10008 - EPO
- SoloCare Standard Gold EPO $2000 DED 10006 - EPO
- SoloCare Standard Platinum EPO $0 DED 10005 - EPO
- SoloCare Standard Silver EPO $6000 DED 10007 - EPO
- BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health� - EPO
- BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health� - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20639051
- Accepts Medicare Assignment
- NO
- Specialities List
- Orthotic Personnel, Prosthetic Personnel.
- Competitive Bidding
- NO
Supplies List
- Orthoses: Custom Fabricated - Custom met pads, Custom heel pads, Custom heel spur pads
- Orthoses: Prefabricated (Non-Custom Fabricated) - Met pads, Heel pads, Heel spur pads
- Orthoses: Off-The-Shelf - Met pads, Heel pads, Heel spur pads
- Limb Prostheses - Prosthetic arms, Prosthetic feet, Prosthetic knees
- Diabetic Shoes and Inserts - Shoes, Socks, Insoles
- Diabetic Shoes/Inserts - Custom - Custom fabricated shoes, socks, & insoles
- Lymphedema Compression Treatment Items -
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 44D2053806
- Facility Type
- Other - CLINICAL RESEARCH OFFICE
- Certificate Effective Date
- February 07, 2025
- Certificate Expiration Date
- February 06, 2027
- Laboratory Director
- RALPH W. STAFFORD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Southeastern Orthotics & Prosthetics, Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for SOUTHEASTERN ORTHOTICS & PROSTHETICS, INC
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1679572655, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 65 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1679572655, enumerated as an "organization" on July 20, 2005.
The provider is located at 316 N HOLTZCLAW AVE CHATTANOOGA, TN 37404 and the phone number is (423) 698-0184.
Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.
The provider might be accepting Accepts: Alliant Health Plans, Inc. and BlueCross. Please consult your insurance carrier or call the provider to verify.
