BI-STATE ORTHOTICS & PROSTHETICS


Address: 6400 W Main St, Suite 3g, Belleville, IL 62223-3806
Phone: 3148432664

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 335E00000X Prosthetic/Orthotic Supplier Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
IL BCBS OF IL 8221629 01
MO BCBS OF MO 122758 01

Office Location

Street Address 6400 W MAIN ST
SUITE 3G
City BELLEVILLE
State IL
Zip Code 62223-3806

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 335E00000X
Grouping Suppliers
Classification Prosthetic/Orthotic Supplier

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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

Competitor

Search similar providers

City BELLEVILLE
Zip Code 62223

Improve Information

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Dataset Information

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.

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