Southern Prosthetic Care LLC
NPI 1063050862 · Prosthetic/Orthotic Supplier · Gulfport, MS
Enrolled with Medicare as Dme Supplier - Certified Orth/Pros/Pedorthist · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Southern Prosthetic Care LLC is a Prosthetic/Orthotic Supplier organization in Gulfport, MS (NPI 1063050862).
Provider details
- NPI number
- 1063050862
- Entity type
- Organization
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Organization subpart
- No
- Authorized official
- William Kenny, Owner(228) 265-7847
Specialties & taxonomies
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (2)
- 1308 44th AveGulfport, MS 39501-2552Phone: (228) 265-7847Fax: (228) 265-7876
- 4201 Highway 11 N Ste DPicayune, MS 39466-2014Phone: (769) 242-2555Fax: (769) 242-2556
Registry dates
- Enumerated
- 2019-12-12
- Last updated
- 2026-02-10
- Certified
- 2026-02-10
Frequently asked questions
- What is Southern Prosthetic Care LLC's NPI number?
- Southern Prosthetic Care LLC's National Provider Identifier (NPI) is 1063050862, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southern Prosthetic Care LLC?
- Southern Prosthetic Care LLC is classified in the NPPES registry as Prosthetic/Orthotic Supplier (Suppliers).
- Where is Southern Prosthetic Care LLC located?
- Southern Prosthetic Care LLC's practice location on file with NPPES is 4410 W Railroad St, Gulfport, MS 39501.
- What is Southern Prosthetic Care LLC's phone number?
- The practice phone number listed in the NPPES registry for Southern Prosthetic Care LLC is (228) 265-7847.
- Does Southern Prosthetic Care LLC accept Medicare?
- Southern Prosthetic Care LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Southern Prosthetic Care LLC?
- The authorized official listed on Southern Prosthetic Care LLC's NPPES record is William Kenny, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southern Prosthetic Care LLC's NPI active?
- Yes — Southern Prosthetic Care LLC's NPI (1063050862) is active in the NPPES registry as of the last update on 2026-02-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.