XTREME PROSTHETICS, LLC. – NPI #1245534585
Prosthetic/Orthotic Supplier

An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.

Health Care Provider Taxonomy Code for Prosthetic/Orthotic Supplier

XTREME PROSTHETICS, LLC. is a DME Supplier located in SOMERSET, KY. NPPES has assigned the NPI number 1245534585 to XTREME PROSTHETICS, LLC. on December 30, 2010. It is a Type-2 NPI, indicating this NPI number is associated with an organization. This provider is also associated with 2 additional names listed below. The primary taxonomy selected by this provider is 335E00000X from the Health Care Provider Taxonomy code set, which is classified as Prosthetic/Orthotic Supplier.

The NPI profile was last updated on May 29, 2026. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for XTREME PROSTHETICS, LLC. below.

NPI Profile for
XTREME PROSTHETICS, LLC.

NPI Number
1245534585
Enumeration Date

(more than 15 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
XTREME PROSTHETICS, LLC.
Other name(s)
All associated names:
Doing Business As (dba)
ForMotion Clinic
Former Legal Business Name
Xtreme Prosthetics & Orthotics, LLC
Primary location
1005 WEST COLUMBIA ST
SUITE B
SOMERSET, KY 42503
Phone: (606) 451-0668 Fax: (606) 451-0078
Mailing address
102 WOODMONT BLVD STE 400
NASHVILLE, TN 37205-5217
Phone: (615) 550-8774 Fax: (615) 454-5352
Organization Subpart
No
Authorized Official
BRADFORD GARDNER
DIRECTOR
Phone: (615) 864-8783
Updated
Certification Date
May 29, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for XTREME PROSTHETICS, LLC.

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherNPIKY1245534585
otherPTANKY6469320001
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
335E00000X
- Prosthetic/Orthotic Supplier (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.