IMPACT PROSTHETIC SOLUTIONS LLC NPI 1255519799

NPI Information

  • NPI: 1255519799
  • Provider Name: IMPACT PROSTHETIC SOLUTIONS, LLC
  • Classification: Prosthetic/Orthotic Supplier - 335E00000X
  • Entity Type: Organization
  • Doing Business As: IMPACT ORTHOPEDICS
  • Address: 3210 PROSPERITY CHURCH RD STE 101
    CHARLOTTE, NC
    ZIP 28269
  • Phone: (704) 510-2204

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NPI Details

IMPACT PROSTHETIC SOLUTIONS, LLC is a prosthetic orthotic supplier in Charlotte, NC. The provider is 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. IMPACT PROSTHETIC SOLUTIONS, LLC NPI is 1255519799. The provider is registered as an organization entity type.
The provider Is Doing Business As Impact Orthopedics.

The provider's business location address is:

3210 PROSPERITY CHURCH RD STE 101
CHARLOTTE, NC
ZIP 28269-194
Phone: (704) 510-2204
Fax: (704) 510-2218

The provider's authorized official is Rico Darryl Phronebarger .
The authorized official title is Co-owner/manager and has the following contact phone number (704) 510-2204.

The enumeration date for this NPI number is 2/6/2008 and was last updated on 6/11/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1335E00000XProsthetic/Orthotic SupplierYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17704797MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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