ORTHODYNAMICS COMPANY, INC.

Provider Demographics

• NPI: 1457310492
• Name: ORTHODYNAMICS COMPANY, INC.
• Entity Type: Organization
• Organization Name: ORTHODYNAMICS COMPANY, INC.
• Authorized Official - Title/Position: PRESIDENT & CEO
• Authorized Official - First Name: ANDREW
• Authorized Official - Middle Name: L
• Authorized Official - Last Name: GIGANTE
• Authorized Official - Phone: 800-497-9107
• Mailing Address - Street 1: 155 CAREY DR
• Mailing Address - City: NOBLESVILLE
• Mailing Address - State: IN
• Mailing Address - Zip Code: 46060-1302
• Mailing Address - Country: US
• Mailing Address - Phone: 800-497-9107
• Mailing Address - Fax: 317-774-0146
• Practice Address - Street 1: 155 CAREY DR
• Practice Address - City: NOBLESVILLE
• Practice Address - State: IN
• Practice Address - Zip Code: 46060-1302
• Practice Address - Country: US
• Practice Address - Phone: 800-497-9107
• Practice Address - Fax: 317-774-0146
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-03-20
• Last Update Date: 2024-02-14

Provider Licenses

State	License ID	Taxonomies
		293D00000X, 332900000X
IN	0007066856	332B00000X, 332BC3200X
IN		335E00000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	332B00000X	Suppliers	Durable Medical Equipment & Medical Supplies
No	293D00000X	Laboratories	Physiological Laboratory
No	332900000X	Suppliers	Non-Pharmacy Dispensing Site
No	332BC3200X	Suppliers	Durable Medical Equipment & Medical Supplies	Customized Equipment
No	335E00000X	Suppliers	Prosthetic/Orthotic Supplier

Provider Identifiers

State	Identifier ID	ID Type	Issuer
LA	3938596	Medicaid
IN	1023695	Other	ACM PROVIDER NUMBER
DE	250693328	Medicaid
TX	403296301	Medicaid
	IN4658	Other	IDTF PTAN
MD	258225200	Medicaid
OR	500823909	Medicaid
IN	IN1859	Other	HEALTHNET PROVIDER NUMBER
IN	0005562645	Other	AETNA PROVIDER NUMBER
FL	108958400	Medicaid
AL	232960	Medicaid
IN	300015837	Medicaid
UT	4115233	Medicaid
KY	90012212	Medicaid
IN	ACS129561000	Other	US DOL PROVIDER NUMBER
IN	000000097460	Other	ANTHEM PROVIDER NUMBER
PA	102394927	Medicaid
WI	1457310492	Medicaid
NJ	0639486	Medicaid
ID	1457310492	Medicaid
VA	1457310492	Medicaid
OH	2503615	Medicaid
IN	80713	Other	NPN PROVIDER NUMBER
GA	003223762A	Medicaid
WA	2223251	Medicaid
KS	30004997060001	Medicaid
AZ	346605	Medicaid
IN	C34913	Other	HUMANA PROVIDER NUMBER
NY	05570576	Medicaid
NC	1457310492	Medicaid
MI	1457310492	Medicaid
NM	68589328	Medicaid
SC	DM1703	Medicaid
TN	Q065153	Medicaid