Provider Demographics
NPI:1376548412
Name:NEXT STEP BIONICS AND PROSTHETICS, INC.
Entity Type:Organization
Organization Name:NEXT STEP BIONICS AND PROSTHETICS, INC.
Other - Org Name:NEXT STEP ORTHOTICS & PROSTHETICS, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:BRADFORD
Authorized Official - Middle Name:
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-864-8783
Mailing Address - Street 1:102 WOODMONT BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-5249
Mailing Address - Country:US
Mailing Address - Phone:615-964-8790
Mailing Address - Fax:615-454-5352
Practice Address - Street 1:155 DOW ST
Practice Address - Street 2:STE 200
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1299
Practice Address - Country:US
Practice Address - Phone:603-668-3831
Practice Address - Fax:603-668-4032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-16
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH1200222Y0NH01OtherANTHEM BCBS
NH30010646Medicaid
NH1120850003Medicare ID - Type UnspecifiedMEDICARE