OTTO BOCK HEALTHCARE LP (NPI# 1760539076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760539076 |
| Entity Type | Organization |
| Organization Name | OTTO BOCK HEALTHCARE LP |
| Practice Address |
3430 J Mckelvey Rd Ste M Bridgeton MO 63044-2556 |
| Mailing Address |
Two Carlson Pkwy - Ste 100 Attn Sharon Clark/contracts Minneapolis MN 55447-4467 |
| Practice Telephone | 3147395311 |
| Practice Fax Number | 8009819557 |
| Mailing Telephone | 7632535679 |
| Mailing Fax Number | 7632535779 |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2008-07-03 |
| Authorized Official Name | SHARON KAY CLARK (PAYOR RELATIONS & CONTRACT ADMIN) |
| Authorized Official Telephone | 7632535679 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | MERCY HEALTH PLANS | 04359876DME | 01 |
| MO | HEALTHLINK PIN # | 464371 | 01 |
| MO | CCN PIN # | 5453317 | 01 |
| MO | AETNA NONHMO PIN # | 7850253 | 01 |
| MO | ANTHEM BCBS MO PIN # | 195724 | 01 |
| MO | NORTHWOOD NPN PIN # | 82108 | 01 |
| MO | ABP DMENSION PIN # | 26106 | 01 |
| MO | USA MCO PIN # | 861099 | 01 |
| MO | ACM PIN # | 1030087 | 01 |
| MO | CARECENTRIX PIN # | 1220 | 01 |
| MS | AETNA HMO PIN # | 2624721 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487913554 | Otto Bock Healthcare Lp | Prosthetic/Orthotic Supplier | 14800 28th Ave N, Suite 110-d, Minneapolis, MN 55447-4873 | 2012-05-10 |
| 1952573255 | Otto Bock Healthcare Lp | Durable Medical Equipment & Medical Supplies | 8570 Cordes Cir, Ste 2, Germantown, TN 38139-3317 | 2008-03-26 |
| 1396926580 | Otto Bock Healthcare Lp | Durable Medical Equipment & Medical Supplies | 8897 Duncan Rd, San Diego, CA 92126-2435 | 2007-11-16 |
| 1174703896 | Otto Bock Healthcare Lp | Durable Medical Equipment & Medical Supplies | 19 Olney Dr, Buffalo, NY 14226-3341 | 2007-11-09 |
| 1407036171 | Otto Bock Healthcare Lp | Durable Medical Equipment & Medical Supplies | 705 Tollgate Rd, Suite F, Elgin, IL 60123-9327 | 2007-11-09 |
| 1194922401 | Otto Bock Healthcare Lp | Durable Medical Equipment & Medical Supplies | 1468 Madison Ave, Box 1241, Guggenheim Pavillion, Mc Level, New York, NY 10029 | 2007-06-29 |
| 1518164276 | Otto Bock Healthcare Lp | Durable Medical Equipment & Medical Supplies | 5012 Oxfordshire Rd, Waxhaw, NC 28173-7324 | 2007-06-27 |
| 1659572352 | Otto Bock Healthcare Lp | Durable Medical Equipment & Medical Supplies | 440 North State Rd 7, Suite F, Royal Palm Beach, FL 33411-3504 | 2007-05-30 |
| 1285845131 | Otto Bock Healthcare Lp | Durable Medical Equipment & Medical Supplies | 1002 Marquette St # B, Bay City, MI 48706-4023 | 2007-05-24 |
| 1003025958 | Otto Bock Healthcare Lp | Durable Medical Equipment & Medical Supplies | 2350 34th St, Lubbock, TX 79411-1634 | 2007-05-21 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | OTTO BOCK HEALTHCARE LP | 11501 Alterra Parkway, Suite 600, Austin, TX 78758 |
| Virginia Business Entities | Otto Bock HealthCare LP | Two Carlson Pkwy North Ste 100, Plymouth, Minnesota 55447 |
| New York State Corporations | OTTO BOCK HEALTHCARE LP | 80 State Street, Albany, New York 12207-2543 |
| Colorado Business Entities | Otto Bock HealthCare LP | 11501 Alterra Parkway, Suite 600, Austin, TX 78758 |
| North Carolina Corporations | Otto Bock Healthcare LP | 2626 Glenwood Avenue, Suite 550, Raleigh, NC 27608 |
| Oklahoma Business Registrations | OTTO BOCK HEALTHCARE LP | Two Carlson Parkway N, Suite 100, Plymouth, MN 55447-4467 |
| Indiana Business Entities | OTTO BOCK HEALTHCARE LP | Two Carlson Pkwy N, Ste 100, Plymouth, MN 55447 |
| Street Address |
3430 J MCKELVEY RD STE M |
| City | BRIDGETON |
| State | MO |
| Zip Code | 63044-2556 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073150017 | Zoe Marie Wadsworth | Nurse Practitioner | 12255 Depaul Dr Suite 300, Bridgeton, MO 63044 | 2019-12-10 |
| 1609412451 | Beyond Better, Best Home Health Care Services, Limited Liability Corpo | In Home Supportive Care | 3430 Mckelvey Road Ste B, Bridgeton, MO 63044 | 2019-11-26 |
| 1275189078 | Delicate Angels Home Health LLC | Home Health | 11726 St. Charles Rock Road Suite G, Bridgeton, MO 63044 | 2019-08-16 |
| 1588210082 | Nicholas Huber | Physical Therapist | 12349 Depaul Dr., Ste. 110, Bridgeton, MO 63044 | 2019-08-12 |
| 1124688858 | Michelle Bassett | Registered Nurse | 11520 St. Charles Rock Rd., Suite 106, Bridgeton, MO 63044 | 2019-06-14 |
| 1336703883 | Elena A Barrow | Nurse Practitioner | 12255 Depaul Dr, Suite 260, Bridgeton, MO 63044 | 2019-04-30 |
| 1487123105 | Laura N Steiner | Registered Nurse | Gateway Pediatrics, Ltd, 12255 Depaul Drive, Suite 460 North Medical Building, Bridgeton, MO 63044 | 2018-11-26 |
| 1205310950 | Danielle Mathis | Nurse Practitioner | 3440 Depaul Lane Suite 201, Bridgeton, MO 63044 | 2018-09-19 |
| 1588163570 | Thoughts Out Loud Counseling, LLC | Social Worker | 11520 St. Charles Rock Road Suite 101, Bridgeton, MO 63044 | 2018-02-06 |
| 1912411430 | Breanna Victoria Hayes | Counselor | 3165 Mckevley Road, Suite 200, Bridgeton, MO 63044 | 2017-11-20 |
| Find all providers in zip 63044 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326558743 | Dan O Asewe | Durable Medical Equipment & Medical Supplies | 12106 Natural Bridge Rd Apt D, Bridgeton, MO 63044-2075 | 2017-10-11 |
| 1528491677 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 12380 Saint Charles Rock Rd, Bridgeton, MO 63044-2504 | 2013-08-13 |
| 1255513784 | Signature Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 12777 De Paul Drive, Suite 305, Bridgeton, MO 63044 | 2007-11-27 |
| 1144301359 | Leon Stotter Healthcare Services | Durable Medical Equipment & Medical Supplies | 65 Manheim Ave, Bridgeton, NJ 08302-2114 | 2006-10-17 |
| 1467551671 | Eckerd Corporation | Durable Medical Equipment & Medical Supplies | 1070 North Pearl Street, Bridgeton, NJ 08302-1215 | 2006-09-22 |
| 1740399161 | Rite Aid of New Jersey Inc | Durable Medical Equipment & Medical Supplies | 52 East Broad Street, Bridgeton, NJ 08302-2831 | 2006-08-30 |
| 1346257359 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 11404 Saint Charles Rock Rd, Bridgeton, MO 63044-2723 | 2006-08-02 |
| 1477568624 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 12345 Saint Charles Rock Rd, Bridgeton, MO 63044-2505 | 2006-07-29 |
| 1619994753 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 1130 Highway 77, Bridgeton, NJ 08302-5988 | 2006-07-16 |
| 1497772743 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 11900 Saint Charles Rock Rd, Bridgeton, MO 63044-2612 | 2006-07-16 |
| Find all providers in BRIDGETON | ||||
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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.