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FORM ORTHOTICS & PROSTHETICS, PLLC
NPI 1740113422
Prosthetic/Orthotic Supplier in Rockford, IL

Q: What is Form Orthotics & Prosthetics, PLLC's NPI number?

The NPI number for Form Orthotics & Prosthetics, PLLC is 1740113422. It was assigned to this organization in the NPPES registry on June 4, 2026.

Q: What is Form Orthotics & Prosthetics, PLLC's specialty?

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

Active since June 04, 2026

4921 E STATE ST LOWR LEVEL, ROCKFORD, IL 61108(402) 212-7878 Get Directions Write a Review

NPPES record added: June 4, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Form Orthotics & Prosthetics, Pllc NPPES

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

FORM ORTHOTICS & PROSTHETICS, PLLC (NPI 1740113422) is a healthcare organization registered as a prosthetic/orthotic supplier in Rockford, Illinois and active in the NPI registry since June 2026. The organization lists Micah Alford, Founder, as its authorized official.

NPPES Registry Identity

NPI1740113422

Entity TypeOrganization

Primary Taxonomy335E00000X

Legal Business NameFORM ORTHOTICS & PROSTHETICS, PLLC

Location Address4921 E STATE ST LOWR LEVELRockford, IL 61108-2275

Mailing Address4921 E State St Lowr LevelRockford, IL 61108-2275

Phone(402) 212-7878

Organization SubpartNo

Authorized OfficialMicah AlfordFounder · (402) 212-7878

Enumeration DateJune 4, 2026

NPPES CertifiedJune 4, 2026

✔ NPI 1740113422 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.

4921 E STATE ST LOWR LEVEL, Rockford, IL 61108

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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 Form Orthotics & Prosthetics, PLLC's NPI number?

The NPI number for Form Orthotics & Prosthetics, PLLC is 1740113422. It was assigned to this organization in the NPPES registry on June 4, 2026.

Where is Form Orthotics & Prosthetics, PLLC located?

Form Orthotics & Prosthetics, PLLC is located at 4921 E State St Lowr Level, Rockford, IL 61108. The listed phone number is (402) 212-7878.

What is Form Orthotics & Prosthetics, PLLC'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 Form Orthotics & Prosthetics, PLLC was last updated on June 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.