Provider Demographics
NPI:1457310492
Name:ORTHODYNAMICS COMPANY, INC.
Entity type:Organization
Organization Name:ORTHODYNAMICS COMPANY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:L
Authorized Official - Last Name:GIGANTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-497-9107
Mailing Address - Street 1:155 CAREY DR
Mailing Address - Street 2:
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 - Street 2:
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
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
293D00000X, 332900000X
IN0007066856332BC3200X, 332B00000X
IN335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No293D00000XLaboratoriesPhysiological Laboratory
No332900000XSuppliersNon-Pharmacy Dispensing Site
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN0005562645OtherAETNA PROVIDER NUMBER
NC1457310492Medicaid
WV1457310492Medicaid
WI1457310492Medicaid
ND1494866Medicaid
MS200014083Medicaid
AL232960Medicaid
OH2503615Medicaid
MD258225200Medicaid
IN300015837Medicaid
NM68589328Medicaid
KY90012212Medicaid
SCDM1703Medicaid
NJ0639486Medicaid
MI1457310492Medicaid
MN1457310492Medicaid
IN4658OtherIDTF PTAN
NY05570576Medicaid
NE10028881000Medicaid
IN1023695OtherACM PROVIDER NUMBER
LA3938596Medicaid
UT4115233Medicaid
TNQ065153Medicaid
AZ346605Medicaid
TX403296301Medicaid
IN80713OtherNPN PROVIDER NUMBER
GA003223762AMedicaid
ID1457310492Medicaid
AK1739283Medicaid
WA2223251Medicaid
ININ1859OtherHEALTHNET PROVIDER NUMBER
FL108958400Medicaid
KS30004997060001Medicaid
PA102394927Medicaid
OK201305850AMedicaid
DE250693328Medicaid
OR500823909Medicaid
INACS129561000OtherUS DOL PROVIDER NUMBER
INC34913OtherHUMANA PROVIDER NUMBER
IN000000097460OtherANTHEM PROVIDER NUMBER
VA1457310492Medicaid