Provider Demographics
NPI:1366034647
Name:INTEGRITY ORTHOTICS AND PROSTHETICS LLC
Entity type:Organization
Organization Name:INTEGRITY ORTHOTICS AND PROSTHETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CO
Authorized Official - Phone:505-437-3900
Mailing Address - Street 1:221 STATE HIGHWAY 165 STE F
Mailing Address - Street 2:
Mailing Address - City:PLACITAS
Mailing Address - State:NM
Mailing Address - Zip Code:87043-9514
Mailing Address - Country:US
Mailing Address - Phone:505-437-3900
Mailing Address - Fax:505-437-3906
Practice Address - Street 1:221 STATE HIGHWAY 165 STE F
Practice Address - Street 2:
Practice Address - City:PLACITAS
Practice Address - State:NM
Practice Address - Zip Code:87043-9514
Practice Address - Country:US
Practice Address - Phone:505-437-3900
Practice Address - Fax:505-437-3906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-08
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Single Specialty
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1982292561OtherNPPES
NM37973576Medicaid