BI-STATE ORTHOTICS & PROSTHETICS (NPI# 1154462950) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1154462950 |
Entity Type | Organization |
Organization Name | BI-STATE ORTHOTICS & PROSTHETICS |
Practice Address |
6400 W Main St Suite 3g Belleville IL 62223-3806 |
Mailing Address |
12660 Lamplighter Sqr Shppng Ctr Suite J Saint Louis MO 63128-2761 |
Practice Telephone | 3148432664 |
Practice Fax Number | 3148423866 |
Mailing Telephone | 3148432664 |
Mailing Fax Number | 3148423866 |
Enumeration Date | 2007-02-12 |
Last Update Date | 2008-06-26 |
Authorized Official Name | MR. MICHAEL J NIEDER (VICE PRESIDENT) |
Authorized Official Telephone | 3148432664 |
Authorized Official Credential | C.O. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | BCBS OF IL | 8221629 | 01 |
MO | BCBS OF MO | 122758 | 01 |
Street Address |
6400 W MAIN ST SUITE 3G |
City | BELLEVILLE |
State | IL |
Zip Code | 62223-3806 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295107563 | Professional Supportive Solution Therapy | Community/Behavioral Health | 6400 W Main St, Belleville, IL 62223-3806 | 2015-10-27 |
1427457019 | April Dawn Jones | Counselor | 6400 W Main St, Ste 1n, Belleville, IL 62223-3806 | 2014-08-19 |
1962630442 | Max L Wood | Social Worker | 6400 W Main St, Suite 1-s, Belleville, IL 62223-3806 | 2009-06-23 |
1285822486 | Helping Hands Healing Hearts | Social Worker | 6400 W Main St, Ste. 1q, Belleville, IL 62223-3806 | 2007-10-12 |
1073705133 | Stuart L Marcus | Social Worker | 6400 W Main St, Ste. 1-s, Belleville, IL 62223-3806 | 2007-08-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699211268 | Vip Home Health Services, LLC | Home Health | 9454 West Main Street Suite B, Belleville, IL 62223 | 2017-01-06 |
1659746063 | Carmel Brown | Counselor | 6400 West Main Suite 3f, Suite 3f, Belleville, IL 62223 | 2015-12-10 |
1558743138 | Patrick Nakashima-moran | Family Medicine | 2900 Frank Scott Pkwy W Ste 904, Belleville, IL 62223 | 2015-06-19 |
1982039921 | Megan Nicole Kirk | Counselor | 8601 W Main St Ste 201, Belleville, IL 62223 | 2013-09-10 |
1043555758 | Toni Green | Physical Therapy Assistant | 400 S 74th St, Belleville, IL 62223 | 2012-12-06 |
1356626949 | Christopher Patrick Gagen | Pharmacist | 5890 North Belt West, Belleville, IL 62223 | 2011-10-15 |
1861777690 | Carmicheal LLC | General Practice | 8601 West Main St., Ste. 101, Belleville, IL 62223 | 2011-10-12 |
1275824096 | Pc Associates LLC | Family Medicine | 2129 W. Main St., Belleville, IL 62223 | 2011-04-27 |
1053616763 | Abdurrahim M Abdulhadi | Anesthesiology | 4500 Mem. Drive, The Memorial Hospital, Belleville, IL 62223 | 2011-01-12 |
1801031695 | Jose Jesus Morales | Anesthesiology | 204 Warrensburg Drive, Belleville, IL 62223 | 2008-12-08 |
Find all providers in zip 62223 |
Taxonomy Code | 335E00000X |
Grouping | Suppliers |
Classification | 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. |
Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053898379 | Boston Brace International Inc. | Prosthetic/Orthotic Supplier | 5 Franklin Ave Ste 407, Belleville, NJ 07109-3565 | 2018-07-20 |
1891230744 | Prima Donna Salon | Prosthetic/Orthotic Supplier | 333 Longview Dr, Belleville, IL 62223-4101 | 2017-01-02 |
1457645566 | Kb Wigs & Beauty Supply | Prosthetic/Orthotic Supplier | 317 Industrial Park Dr, Belleville, MI 48111-2901 | 2011-06-06 |
1417108630 | A New Beginning Healing Hand | Prosthetic/Orthotic Supplier | 504 Main St, Suite B, Belleville, MI 48111-2839 | 2008-10-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952909517 | Matayah Love | Prosthetic/Orthotic Supplier | 5833 W Madison St, Chicago, IL 60644-3840 | 2020-10-15 |
1225653686 | Bionic Prosthetics and Orthotics Group LLC | Prosthetic/Orthotic Supplier | 1290 W Northwest Hwy, Palatine, IL 60067-1897 | 2020-06-11 |
1710508239 | Vivian Danielle Williams | Prosthetic/Orthotic Supplier | 940 N Monticello Ave # 1, Chicago, IL 60651-3949 | 2020-05-06 |
1265053136 | Dfined Beauty LLC | Prosthetic/Orthotic Supplier | 1507 E 53rd St # 835, Chicago, IL 60615-4573 | 2020-05-02 |
1134748767 | The Weave Luxe Bar | Prosthetic/Orthotic Supplier | 7315 Lemont Rd, Downers Grove, IL 60516-3807 | 2020-04-14 |
1245865245 | Ortheco LLC | Prosthetic/Orthotic Supplier | 3050 Montvale Dr Ste E, Springfield, IL 62704-4290 | 2020-03-10 |
1417515784 | Dionne Williams Group | Prosthetic/Orthotic Supplier | 6822 S Wood St, Chicago, IL 60636-3337 | 2019-06-03 |
1164080743 | Bionic Prosthetics and Orthotics Group LLC | Prosthetic/Orthotic Supplier | 391 Quadrangle Dr Ste N4, Bolingbrook, IL 60440-3443 | 2019-05-30 |
1760047583 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 13500 Circle Dr Ste 202, Orland Park, IL 60462-1343 | 2019-05-07 |
1114580107 | Thomas Gavin | Prosthetic/Orthotic Supplier | 1010 Jorie Blvd Ste 24, Oak Brook, IL 60523-4450 | 2019-04-16 |
Find all providers with the same taxonomy |
City | BELLEVILLE |
Zip Code | 62223 |
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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.