MEDICARE: RENEWED MOBILITY PROSTHETICS AND MARTHA ELIZABETH MATTHEWS SOLE MBR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1386506954
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENEWED MOBILITY PROSTHETICS AND MARTHA ELIZABETH MATTHEWS SOLE MBR

Provider Business Mailing Address
First Line	:	816 SOUTHWEST DR
Second Line	:
City	:	DAVIDSON
State	:	NC
Zip	:	28036-8922
Country	:	US
Telephone Number	:	704-448-9000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1816 N BRIDGE ST
Second Line	:
City	:	ELKIN
State	:	NC
Zip	:	28621-2104
Country	:	US
Telephone Number	:	704-448-9000
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRACTITION
Name	:	MARTHA ELIZABETH MATTTHEWS
Credential	:	CPO
Telephone Number	:	704-448-9000

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/02/2025

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