MAGER & GOUGELMAN OF ST. LOUIS, LLC (NPI# 1437783776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437783776 |
| Entity Type | Organization |
| Organization Name | MAGER & GOUGELMAN OF ST. LOUIS, LLC |
| Practice Address |
1034 S Brentwood Blvd Ste 1880 Richmond Heights MO 63117-1218 |
| Practice Telephone | 3147261818 |
| Practice Fax Number | 3147260295 |
| Mailing Telephone | 3147261818 |
| Mailing Fax Number | 3147260295 |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2020-02-25 |
| Authorized Official Name | MR. TODD MICHAEL CHILES (OWNER) |
| Authorized Official Telephone | 3147261818 |
| Authorized Official Credential | BCO, BADO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| Street Address |
1034 S BRENTWOOD BLVD STE 1880 |
| City | RICHMOND HEIGHTS |
| State | MO |
| Zip Code | 63117-1218 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255956611 | Efehi Kelly Ogbomo | Student in an Organized Health Care Education/Training Program | 6420 Clayton Rd, Suite 2218, St. Louis, MO 63117 | 2020-06-11 |
| 1619533890 | Abdul Rauf | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road. Ssm Health St. Mary's Hospital, St. Louis, MO 63117 | 2019-05-14 |
| 1083278477 | Mohamed Maali Gumaa Mohamed | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road Ssm St. Mary's Hospital, Department of Internal Medicine, St. Louis, MO 63117 | 2019-05-01 |
| 1750945556 | Samrat Jun Jayanth | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm Health St Mary's Hospital, St. Louis, MO 63117 | 2019-04-26 |
| 1215491329 | Latonya Allen | Counselor | 1612 S. Big Bend Blvd, St. Louis, MO 63117 | 2019-01-23 |
| 1265917025 | Blue Stars Therapy, LLC | Occupational Therapist | 1101 Edward Terrace, Apt A, St. Louis, MO 63117 | 2018-09-27 |
| 1770060014 | Ultra Care Home Services LLC | Home Health | 7353 Dale Ave, Saint Louis, MO 63117 | 2018-07-19 |
| 1235623562 | Melissa Valerie Taylor | Counselor | Psychological Services of St Louis, LLC, 7110 Oakland Ave, St Louis, MO 63117 | 2018-06-20 |
| 1124517289 | Jideofor Ebony Obodozie | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm St. Mary's Hospital, St. Louis, MO 63117 | 2018-05-04 |
| 1770071706 | Sivaram Prabhuji Muppaneni | Student in an Organized Health Care Education/Training Program | Ssm St Mary's Hospital, 6420 Clayton Road, St. Louis, MO 63117 | 2018-04-25 |
| Find all providers in zip 63117 | ||||
| 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 |
|---|---|---|---|---|
| 1154769982 | Coburn Solutions LLC | Prosthetic/Orthotic Supplier | 170 Richmond Rd, Richmond Heights, OH 44143-1239 | 2013-06-14 |
| 1265721153 | Nordstrom Inc & Subsidiaries | Prosthetic/Orthotic Supplier | 1453 Saint Louis Galleria, Richmond Heights, MO 63117-1112 | 2011-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497355689 | Hair On The Edge | Prosthetic/Orthotic Supplier | 9708 Lackland Rd, Overland, MO 63114-3414 | 2020-10-28 |
| 1427656727 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 755 S New Ballas Rd Ste 140, Saint Louis, MO 63141-8713 | 2020-10-09 |
| 1962042440 | Fourroux Prosthetics, Inc | Prosthetic/Orthotic Supplier | 9665 Page Avenue, Overland, MO 63132 | 2020-01-13 |
| 1407496201 | Ortheco LLC | Prosthetic/Orthotic Supplier | 2907 Independence St Ste D, Cape Girardeau, MO 63703-5027 | 2020-01-09 |
| 1477100717 | Desirae Clark | Prosthetic/Orthotic Supplier | 5100 Lydia Ave, Kansas City, MO 64110-2608 | 2019-08-21 |
| 1720540313 | Axes Physical Therapy, LLC | Prosthetic/Orthotic Supplier | 754 Luetkenhaus Blvd, Wentzville, MO 63385-3515 | 2019-04-02 |
| 1093272460 | Axes Physical Therapy I, LLC | Prosthetic/Orthotic Supplier | 2018 Phoenix Center Dr, Washington, MO 63090-5544 | 2019-02-21 |
| 1215400312 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 4801 Main St Ste 220, Kansas City, MO 64112-2929 | 2019-01-10 |
| 1649778382 | Boston Brace International Inc. | Prosthetic/Orthotic Supplier | 50 Crestwood Executive Ctr Ste 315, Saint Louis, MO 63126-1900 | 2018-01-29 |
| 1356858971 | Monique Renee Wigs and Etc | Prosthetic/Orthotic Supplier | 12123 Blue Ridge Ext Ste C, Grandview, MO 64030-1194 | 2018-01-04 |
| Find all providers with the same taxonomy | ||||
| City | RICHMOND HEIGHTS |
| Zip Code | 63117 |
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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.