PREMIER PROSTHETICS AND ORTHOTICS (NPI# 1003045436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003045436 |
| Entity Type | Organization |
| Organization Name | PREMIER PROSTHETICS AND ORTHOTICS |
| Practice Address |
343 S Kirkwood Rd Ste 200 Saint Louis MO 63122-6195 |
| Practice Telephone | 3142628900 |
| Practice Fax Number | 3147433575 |
| Mailing Telephone | 3142628900 |
| Mailing Fax Number | 3147433575 |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2018-10-26 |
| Authorized Official Name | MR. GREGORY MICHAEL DOERR (OWNER) |
| Authorized Official Telephone | 3142628900 |
| Authorized Official Credential | CPO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | B00326665 | MO | Suppliers |
| Street Address |
343 S KIRKWOOD RD STE 200 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63122-6195 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447656038 | Elissa Lanetharp | Case Manager/Care Coordinator | 343 S Kirkwood Rd Ste 200, Saint Louis, MO 63122-6195 | 2014-11-10 |
| 1679827422 | Precious Grimes | Counselor | 343 S Kirkwood Rd Ste 200, Saint Louis, MO 63122-6195 | 2012-11-01 |
| 1710263520 | Aziza N/a Siddiqui | Case Manager/Care Coordinator | 343 S Kirkwood Rd Ste 200, Saint Louis, MO 63122-6195 | 2011-10-25 |
| 1063729119 | Shannon Christine Pultz | Case Manager/Care Coordinator | 343 S Kirkwood Rd Ste 200, Saint Louis, MO 63122-6195 | 2010-09-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659933174 | Keela Rushing | Physical Therapist | 439 S Kirkwood Rd Ste 200, Kirkwood, MO 63122 | 2019-07-04 |
| 1730643461 | Kirkwood Family Dental | Dentist | 333 S Kirkwood Road, Suite 105, Kirkwood, MO 63122 | 2019-01-28 |
| 1477061166 | Total Access Urgent Care, PC | Clinic/Center | 2980 Dougherty Ferry Rd, Saint Louis, MO 63122 | 2018-01-16 |
| 1760933469 | Missouri Cvs Pharmacy, L.l.c | Durable Medical Equipment & Medical Supplies | 10820 Manchester Rd, Kirkwood, MO 63122 | 2016-10-18 |
| 1518321041 | M. Kathleen Blanchard | Counselor | 11042 Manchester Rd., Kirkwood, MO 63122 | 2016-04-11 |
| 1265801914 | Kim Grega | Counselor | 700 S Kirkwood Rd, Kirkwood, MO 63122 | 2015-09-23 |
| 1245617943 | Mark Edward Taylor | Dentist | 610 North Geyer, Kirkwood, MO 63122 | 2015-05-01 |
| 1467843094 | Mary Elizabeth Boomgarden | Physical Therapist | 9645 Big Bend Boulevard, Saint Louis, MO 63122 | 2015-02-18 |
| 1760725717 | Michael Diller Counseling | Counselor | 144 W Madison Avenue, Kirkwood, MO 63122 | 2013-03-28 |
| 1427309954 | Anne Marie Delaplain | Dentist | 725 Laclede Station Road, Webster Groves, MO 63122 | 2012-09-24 |
| Find all providers in zip 63122 | ||||
| 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 |
|---|---|---|---|---|
| 1427656727 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 755 S New Ballas Rd Ste 140, Saint Louis, MO 63141-8713 | 2020-10-09 |
| 1649778382 | Boston Brace International Inc. | Prosthetic/Orthotic Supplier | 50 Crestwood Executive Ctr Ste 315, Saint Louis, MO 63126-1900 | 2018-01-29 |
| 1730631417 | Health Tech Staffing Network | Prosthetic/Orthotic Supplier | 2122 Kratky Rd Ste 100, Saint Louis, MO 63114-1706 | 2016-10-28 |
| 1659535854 | Prosthetic and Orthotic Care Inc | Prosthetic/Orthotic Supplier | 1084 Old Des Peres Rd, Saint Louis, MO 63131-1865 | 2008-07-16 |
| 1487816583 | Bi-state Orthotics and Prosthetics | Prosthetic/Orthotic Supplier | 12660 Lamplighter Sqr Shppng Ctr, Suite J, Saint Louis, MO 63128-2761 | 2008-06-30 |
| 1720255821 | Bsop, LLC | Prosthetic/Orthotic Supplier | 11229 Concord Village Ave, Saint Louis, MO 63123-6903 | 2008-05-08 |
| 1649490574 | Contemporary Healthcare Consulting Inc | Prosthetic/Orthotic Supplier | 5416 Southfield Ctr, Saint Louis, MO 63123-5907 | 2007-04-25 |
| 1356442396 | B & H Orthopedic Lab Inc. | Prosthetic/Orthotic Supplier | 2510 Hampton Ave, Saint Louis, MO 63139-2911 | 2006-09-25 |
| 1801861505 | Cape Prosthetics-orthotics, Inc. | Prosthetic/Orthotic Supplier | 2262 Weldon Pkwy, Saint Louis, MO 63146-3206 | 2006-02-17 |
| 1578562831 | Wrymark, Inc | Prosthetic/Orthotic Supplier | 11833 Westline Industrial Dr, Saint Louis, MO 63146-3312 | 2005-07-19 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63122 |
Please comment or provide details below to improve the information on PREMIER PROSTHETICS AND ORTHOTICS.
| 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.