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PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES-SOUTHEAST, LLC
NPI 1912303330
Prosthetic/Orthotic Supplier in Shreveport, LA

Active since November 12, 2014
3100 SAMFORD AVE, SHREVEPORT, LA 71103(318) 226-3310(318) 226-4294 Get Directions Write a Review

NPPES record last updated: April 23, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Pediatric Orthotic And Prosthetic Services-southeast, Llc NPPES

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

PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES-SOUTHEAST, LLC (NPI 1912303330) is a healthcare organization registered as a prosthetic/orthotic supplier in Shreveport, Louisiana and active in the NPI registry since November 2014. The organization lists Joseph Anthony Gomez, Director Of O&p, as its authorized official.

NPPES Registry Identity

NPI1912303330
Entity TypeOrganization
Primary Taxonomy335E00000X
Legal Business NamePEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES-SOUTHEAST, LLC
Location Address3100 SAMFORD AVEShreveport, LA 71103-4239
Mailing AddressPo Box 947109Atlanta, GA 30394-7109 · (318) 226-3310 · Fax (813) 226-4294
Phone(318) 226-3310
Fax(318) 226-4294
Organization SubpartYes
Authorized OfficialJoseph Anthony GomezDirector Of O&p · (318) 226-4279
Enumeration DateNovember 12, 2014
Last NPPES UpdateApril 23, 2025
NPPES CertifiedApril 23, 2025
✔ NPI 1912303330 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.
3100 SAMFORD AVE, Shreveport, LA 71103
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, CHRISTUS Health Plan, HMO Louisiana.Insurance ›

Medical Equipment Supplier Medicare DMEPOS 6

Medicare supplier enrollment and the product categories Pediatric Orthotic And Prosthetic S carries, from the Medicare DMEPOS supplier directory.

Pediatric Orthotic And Prosthetic S

DMEPOS supplier · Shreveport, LAOperated by Pediatric Orthotic And Prosthetic Services - Southeast, LLC
⋮

Does not accept Medicare assignment

Pediatric Orthotic And Prosthetic S has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20477891
Medicare Participant SinceJune 9, 2016
Supplier Location3100 Samford AveShreveport, LA 71103
Phone(318) 226-3310
Supplier Specialties
MSC With Orthotic Personnel MSC With Prosthetic Personnel MSC With Orthotic-Prosthetic Orthotic Personnel Prosthetic Personnel

Medicare Product Categories

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
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 20

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

LYNN GIBBS JENKINS LOTR
Occupational Therapist (Pediatrics)
3100 SAMFORD AVE
SHREVEPORT, LA 71103
Caddo Parish (318) 222-5704
MRS. AMANDA CARFAGNO NP
Nurse Practitioner (Pediatrics)
3100 SAMFORD AVE
SHREVEPORT, LA 71103
Caddo Parish (318) 226-3306
SUSAN H. THORNHILL
Occupational Therapist
3100 SAMFORD AVE
SHREVEPORT, LA 71103
Caddo Parish (318) 226-3329
DAMIAN JUDE DUHON PT, DPT
Physical Therapist
3100 SAMFORD AVE
SHREVEPORT, LA 71103
Caddo Parish (318) 226-4219
MRS. SUSAN SAYLORS BRYANT P.T.
Physical Therapist
3100 SAMFORD AVE
SHREVEPORT, LA 71103
Caddo Parish (318) 222-5704
DR. GERARD KARL WILLIAMS JR. M.D.
Orthopaedic Surgery (Pediatric Orthopaedic Surgery)
3100 SAMFORD AVE
SHREVEPORT, LA 71103
Caddo Parish (318) 222-5704
KENNETH PATRICK POWELL MD
Orthopaedic Surgery (Pediatric Orthopaedic Surgery)
3100 SAMFORD AVE
SHREVEPORT, LA 71103
Caddo Parish (318) 226-3306
MS. SHANNON MARIE MORAN PT
Physical Therapist (Pediatrics)
3100 SAMFORD AVE
SHREVEPORT, LA 71103
Caddo Parish (318) 222-5704

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 Pediatric Orthotic And Prosthetic Services-Southeast, LLC's NPI number?

The NPI number for Pediatric Orthotic And Prosthetic Services-Southeast, LLC is 1912303330. It was assigned to this organization in the NPPES registry on November 12, 2014.

Where is Pediatric Orthotic And Prosthetic Services-Southeast, LLC located?

Pediatric Orthotic And Prosthetic Services-Southeast, LLC is located at 3100 Samford Ave, Shreveport, LA 71103. The listed phone number is (318) 226-3310.

What is Pediatric Orthotic And Prosthetic Services-Southeast, LLC's specialty?

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

Does Pediatric Orthotic And Prosthetic Services-Southeast, LLC accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Pediatric Orthotic And Prosthetic S does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

What insurance does Pediatric Orthotic And Prosthetic Services-Southeast, LLC accept?

Health plans from Blue Cross and Blue Shield of Louisiana, CHRISTUS Health Plan and HMO Louisiana list Pediatric Orthotic And Prosthetic Services-Southeast, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pediatric Orthotic And Prosthetic Services-Southeast, LLC was last updated on April 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.