NATIONAL PEDORTHIC SERVICES, INC. (NPI# 1649450966) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649450966 |
| Entity Type | Organization |
| Organization Name | NATIONAL PEDORTHIC SERVICES, INC. |
| Practice Address |
4804 S State Route 159 Suite A Glen Carbon IL 62034-1904 |
| Mailing Address |
7283 W Appleton Ave Milwaukee WI 53216-1932 |
| Practice Telephone | 4144381211 |
| Mailing Telephone | 4144381211 |
| Enumeration Date | 2007-11-05 |
| Last Update Date | 2007-11-05 |
| Authorized Official Name | MRS. NICOLE S JANISSE (CORPORATE FACILITY MANAGER) |
| Authorized Official Telephone | 4144381211 |
| Is Organization Subpart | Y |
| Parent Organization Name | NATIONAL PEDORTHIC SERVICES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851405518 | National Pedorthic Services, Inc. | Prosthetic/Orthotic Supplier | 1334 Applegate Rd, Suite 200, Madison, WI 53713-3184 | 2006-08-19 |
| 1083728653 | National Pedorthic Services, Inc. | Prosthetic/Orthotic Supplier | 1280 Scottsville Rd, Suite 20, Rochester, NY 14624-5147 | 2006-08-19 |
| 1215041884 | National Pedorthic Services, Inc. | Prosthetic/Orthotic Supplier | 727 N New Ballas Rd, Creve Coeur, MO 63141-6715 | 2006-08-19 |
| 1205816857 | National Pedorthic Services, Inc. | Prosthetic/Orthotic Supplier | 2475 N 124th St, Brookfield, WI 53005-4630 | 2006-01-19 |
| 1316051063 | National Pedorthic Services, Inc. | Prosthetic/Orthotic Supplier | 2745 W Layton Ave, Suite 103, Milwaukee, WI 53221-2651 | 2006-08-19 |
| 1548374101 | National Pedorthic Services, Inc. | Prosthetic/Orthotic Supplier | 885 Western Ave, Suite 400, Fond Du Lac, WI 54935-3874 | 2006-08-19 |
| Street Address |
4804 S STATE ROUTE 159 SUITE A |
| City | GLEN CARBON |
| State | IL |
| Zip Code | 62034-1904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053406694 | Staci R Young | Pediatrics | 4804 S State Route 159, Glen Carbon, IL 62034-1904 | 2006-10-03 |
| 1720165426 | Laboratoryt Corporation of America | Clinical Medical Laboratory | 4804 S State Route 159, Glen Carbon, IL 62034-1904 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740787795 | Kaleena Galletta | Nurse Practitioner | 4273 S., Il - 159, Glen Carbon, IL 62034 | 2018-04-06 |
| 1871092502 | Andrea Lee Sullivan | Dentist | 3024 South Il-159, Glen Carbon, IL 62034 | 2018-02-08 |
| 1417464918 | Stages Health & Wellness, LLC | Nurse Practitioner | 14 Crabapple Lane, Glen Carbon, IL 62034 | 2018-01-05 |
| 1700300498 | Michael Jay Arnold | Dentist | 3024 Il-159, Glen Carbon, IL 62034 | 2017-08-03 |
| 1679024228 | 360 Body Wellness Inc | Internal Medicine | 3407 Il State Route 157, Glen Carbon, IL 62034 | 2016-10-19 |
| 1346621505 | Stephanie N Lorts | Pediatrics | 4804 South State Route 159, Glen Carbon, IL 62034 | 2015-06-13 |
| 1205110111 | James Allan Staley | Pharmacist | #2 Cottonwood Rd, Glen Carbon, IL 62034 | 2011-10-11 |
| 1215224357 | Angela Eleni Kioultzopoulos | Speech-Language Pathologist | 7a Ginger Creek Village Dr., Glen Carbon, IL 62034 | 2011-07-08 |
| 1922320795 | Meridian Village Association | Skilled Nursing Facility | 27 Auerbach Place, Glen Carbon, IL 62034 | 2010-02-22 |
| 1679728356 | Erin Kathleen Immken | Counselor | 98 Junction Drive West, Suite 6, Glen Carbon, IL 62034 | 2008-11-24 |
| Find all providers in zip 62034 | ||||
| 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 |
|---|---|---|---|---|
| 1558485987 | Joshua C Allison | Prosthetic/Orthotic Supplier | 4225 S State Route 159, Ste 1, Glen Carbon, IL 62034-3231 | 2007-03-19 |
| 1396985297 | New Step Orthotic Lab, Inc | Prosthetic/Orthotic Supplier | 4225 S State Route 159, Ste 1, Glen Carbon, IL 62034-3231 | 2009-03-05 |
| 1740304153 | Joshua C Allison | Prosthetic/Orthotic Supplier | 4225 S State Route 159, Ste 1, Glen Carbon, IL 62034-3231 | 2007-03-19 |
| 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 | GLEN CARBON |
| Zip Code | 62034 |
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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.