VISAGE STUDIOS, LLC (NPI# 1023382116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023382116 |
| Entity Type | Organization |
| Organization Name | VISAGE STUDIOS, LLC |
| Other Organization Name | VISAGE CUSTOM PROSTHETICS |
| Practice Address |
53 E Johnson St Bonne Terre MO 63628-1773 |
| Practice Telephone | 3147322658 |
| Mailing Telephone | 3147322658 |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2012-03-07 |
| Authorized Official Name | AMANDA BEHR (ANAPLASTOLOGIST) |
| Authorized Official Telephone | 3147322658 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 229N00000X | Anaplastologist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Other Name | Type Code |
|---|---|
| Visage Custom Prosthetics | Doing Business As Name - Organization |
| Street Address |
53 E JOHNSON ST |
| City | BONNE TERRE |
| State | MO |
| Zip Code | 63628-1773 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437675477 | Kybama, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 12729 Stoney Point Rd, Bonne Terre, MO 63628 | 2017-08-22 |
| 1295092500 | Jak Properties Inc | In Home Supportive Care | 522 Benham St, Suite B, Bonne Terre, MO 63628 | 2012-04-12 |
| 1013121599 | Joseph Richard Engel | Dentist | 20 W Johnson St, Bonne Terre, MO 63628 | 2007-05-10 |
| 1215093844 | Debra Long Morgan | Dentist | 20 West Johnson Street, Bonne Terre, MO 63628 | 2006-12-28 |
| 1497811459 | Robert Oliver Greenwald | Dentist | #20 W Johnson, Bonne Terre, MO 63628 | 2006-12-27 |
| 1255964508 | American Nursing & Rehab LLC | Assisted Living Facility | 10 Lake Drive, Bonne Terre, MO 63628 | 2020-02-14 |
| 1962679746 | Robert O Greenwald Dds PC | Dentist | #20 W Johnson, Bonne Terre, MO 63628 | 2008-05-12 |
| 1427045004 | Pairat Vibulakaopun | Internal Medicine | 527 Benham St, Bonne Terre, MO 63628-1205 | 2005-09-29 |
| 1124014030 | Kenny Ratana | Radiology | 527 Benham St # B, Bonne Terre, MO 63628-1205 | 2005-09-26 |
| 1669017315 | Patricia Ann Peterson | Nurse Practitioner | 527 Benham St, Bonne Terre, MO 63628-1205 | 2019-11-15 |
| Find all providers in zip 63628 | ||||
| Taxonomy Code | 229N00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Anaplastologist |
| An anaplastologist is a professional who creates prostheses for the face and body. Patients treated include those missing anatomy due to cancer, traumatic injury, or birth differences. Generally, there are no state licensing requirements for anaplastologists. Certification specific to anaplastology is provided through the Board for Certified Clinical Anaplastology (BCCA) with a credential title of Certified Clinical Anaplastologist (CCA). |
| Notes: Source: American Anaplastology Association, www.anaplastology.org. [7/1/2006: new] |
| City | BONNE TERRE |
| Zip Code | 63628 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.