Healthcare Provider Details

I. General information

NPI: 1053395350
Provider Name (Legal Business Name): ORTHOSOURCE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13839 INDUSTRIAL RD
OMAHA NE
68137-1117
US

IV. Provider business mailing address

13839 INDUSTRIAL RD
OMAHA NE
68137-1117
US

V. Phone/Fax

Practice location:
  • Phone: 402-408-0777
  • Fax: 402-933-5523
Mailing address:
  • Phone: 402-408-0777
  • Fax: 402-933-5523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: STEVE RONSPIES
Title or Position: MANAGER/ATHLETIC TRAINER
Credential: ATC
Phone: 402-861-6683