VICTORY ORTHOTICS & PROSTHETICS LLC NPI 1891935763

Prosthetic/Orthotic Supplier in Kingsport, TN

Organization Prosthetic/Orthotic Supplier Medicare Supplier Does Not Accept Medicare Approved Payment

About VICTORY ORTHOTICS & PROSTHETICS LLC

Victory Orthotics & Prosthetics Llc is a provider established in Kingsport, Tennessee specializing in Prosthetic/orthotic Supplier. The NPI number of Victory Orthotics & Prosthetics Llc is 1891935763 and was assigned on March 2009. The practitioner's primary taxonomy code is 335E00000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Mr. Brad Gardner (Coo)

NPI

1891935763

Provider NameVICTORY ORTHOTICS & PROSTHETICS LLC
Provider Location Address2 SHERIDAN SQ SUITE 100 KINGSPORT, TN 37660
Provider Mailing Address2 SHERIDAN SQ SUITE 100 KINGSPORT, TN 37660
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date03-04-2009
Last Update Date10-03-2018



Victory Orthotics & Prosthetics Llc is a medicare supplier with PTAN 4273920004 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.



Primary Taxonomy

Taxonomy Code335E00000X
ClassificationProsthetic/Orthotic Supplier
TypeSuppliers
License StateTN
Taxonomy DescriptionAn 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.

Business Address

VICTORY ORTHOTICS & PROSTHETICS LLC
2 SHERIDAN SQ
SUITE 100
KINGSPORT, TN
ZIP 37660
Phone: (423) 378-3320
Fax: (423) 378-3363

Get Directions


Mailing Address

VICTORY ORTHOTICS & PROSTHETICS LLC
2 SHERIDAN SQ
SUITE 100
KINGSPORT, TN
ZIP 37660
Phone: (423) 378-3320
Fax: (423) 378-3363


Authorized Official

Authorized Official NameMR. BRAD GARDNER
Authorized Official TitleCOO
Authorized Official Phone(615) 864-8790

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN4273920004
Accepts Medicare AssignmentNO
Specialities ListOrthotic Personnel, Prosthetic Personnel.
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
Competitive BiddingNO

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
4017529OTHER (01)TNBCBST
9190601MEDICAID (05)VA
1454184MEDICAID (05)TN

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1891935763
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2818118310712
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 8 + 1 + 8 + 1 + 1 + 8 + 3 + 1 + 0 + 7 + 1 + 2 + 24 = 67
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 67 = 33

The NPI number 1891935763 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the same location


The following 7 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1720097702 EMILE GEORGE SCHMIDT JR. PT
Individual
Physical Therapist2 SHERIDAN SQ SUITE 200
KINGSPORT, TN 37660
(423) 246-8061
1871502880BLUE RIDGE NEUROSCIENCE CENTER, P.C.
Organization
Specialist2 SHERIDAN SQ STE 200
KINGSPORT, TN 37660
(423) 392-2887
1699048066MRS. ELIZABETH MICHELLE CRAWFORD ACNP
Individual
Nurse Practitioner (Acute Care)2 SHERIDAN SQ SUITE 200
KINGSPORT, TN 37660
(423) 246-8061
1275525354MS. CARLA RENEE CHEEK FNP
Individual
Nurse Practitioner (Family)2 SHERIDAN SQ SUITE 200
KINGSPORT, TN 37660
(423) 392-2887
1649656240 BONNIE HENLEY FNP
Individual
Nurse Practitioner (Family)2 SHERIDAN SQ STE 200
KINGSPORT, TN 37660
(423) 246-8061
1609311349MRS. MELISSA HOPE FORD RN
Individual
Registered Nurse (Neuroscience)2 SHERIDAN SQ
KINGSPORT, TN 37660
(423) 246-8061
1033101126 KENNETH WAYNE SMITH MD
Individual
Neurological Surgery2 SHERIDAN SQ SUITE 200
KINGSPORT, TN 37660
(423) 246-8061

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Victory Orthotics & Prosthetics Llc is registered as an entity type code: 2. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.