=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124039151
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOME CARE ORTHOTICS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/11/2006
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 917 DOLLY PARTON PARKWAY
-----------------------------------------------------
City | SEVIERVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37862
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-774-9959
-----------------------------------------------------
Fax | 865-774-9953
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 917 DOLLY PARTON PARKWAY
-----------------------------------------------------
City | SEVIERVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37862
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-774-9959
-----------------------------------------------------
Fax | 865-774-9953
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE PRESIDENT OFFICE MANAGER
-----------------------------------------------------
Name | MRS. MISTY DAWN BRACKINS
-----------------------------------------------------
Credential | VICE PRESIDENT
-----------------------------------------------------
Telephone | 865-774-9959
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 335E00000X
-----------------------------------------------------
Taxonomy Name | Prosthetic/Orthotic Supplier
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 335E00000X
-----------------------------------------------------
Taxonomy Name | Prosthetic/Orthotic Supplier
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------