THE MASTECTOMY CENTER (NPI# 1245363076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245363076 |
| Entity Type | Organization |
| Organization Name | THE MASTECTOMY CENTER |
| Practice Address |
4201 S Noland Rd Suite I Independence MO 64055-7313 |
| Practice Telephone | 8163733447 |
| Practice Fax Number | 8163733447 |
| Mailing Telephone | 8163733447 |
| Mailing Fax Number | 8163733447 |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DIXIE N STRETZ (CO OWNER) |
| Authorized Official Telephone | 8163733447 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | CFM01450 | MO | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 36532017 | 01 |
| Street Address |
4201 S NOLAND RD SUITE I |
| City | INDEPENDENCE |
| State | MO |
| Zip Code | 64055-7313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972910636 | Jami Montesano | Pharmacist | 4201 S Noland Rd, Independence, MO 64055-7313 | 2014-07-15 |
| 1184921223 | Brad Alan Wolzak | Pharmacist | 4201 S Noland Rd, Independence, MO 64055-7313 | 2011-02-25 |
| 1881860609 | Healthy Solutions, Inc. | Public Health or Welfare | 4201 S Noland Rd, Independence, MO 64055-7313 | 2008-05-01 |
| 1063698827 | Medbasics Missouri LLC | Clinic/Center | 4201 S Noland Rd, Independence, MO 64055-7313 | 2008-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851916035 | Nicholas Portell | Optometrist | 13900 E Us Hwy, Suite A, Independence, MO 64055 | 2020-06-12 |
| 1295396398 | Alyson Forbes | Behavioral Analyst | 4721 S. Cliff Ave, Suite 103, Independence, MO 64055 | 2019-06-28 |
| 1427526458 | Physicians Wellness Group LLC | Family Medicine | 19045 E Valley View Parkway, Suite G, Independence, MO 64055 | 2018-11-07 |
| 1760967707 | Simone Lila Light | Behavioral Analyst | 4721 S. Cliff Ave Suite 103, Suite 103, Independence, MO 64055 | 2018-09-25 |
| 1841786183 | Ladonna Kaye Stephens | Pharmacist | 4100 Bolger Dr, Independence, MO 64055 | 2018-07-10 |
| 1568954873 | Lincare Inc | Durable Medical Equipment & Medical Supplies | 17501 E 40 Hwy Ste 224, Independence, MO 64055 | 2018-06-01 |
| 1710488002 | Zenith Rehabilitation, LLC | Rehabilitation Practitioner | 14500 E 42nd St S Ste 240, Independence, MO 64055 | 2018-02-22 |
| 1720526924 | Ashley & Gray D.d.s.'s | Clinic/Center | 1520 E 23rd Str, Ste Q, Independence, MO 64055 | 2017-02-08 |
| 1942751045 | Mary C Younger | Counselor | 4710 S Cedar Crest Ct Ste 100, Independence, MO 64055 | 2016-10-24 |
| 1497163950 | Carolyn J Wells | Home Health Aide | 13308 E 43rd Terr S, Independence, MO 64055 | 2014-07-29 |
| Find all providers in zip 64055 | ||||
| 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 |
|---|---|---|---|---|
| 1205370038 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 6055 Rockside Woods Blvd, Suite 170, Independence, OH 44131-2301 | 2016-12-13 |
| 1588896781 | Horizon Orthotic & Prosthetic Experience Inc | Prosthetic/Orthotic Supplier | 4900 S. Arrowhead Dr. Ste. A, Independence, MO 64055-6990 | 2009-08-20 |
| 1356336507 | Kansas City Artificial Limbs Inc. | Prosthetic/Orthotic Supplier | 9302 E 40 Hwy, Independence, MO 64055-6111 | 2005-09-14 |
| 1770583684 | Monterey Park Nursing Center, Inc | Prosthetic/Orthotic Supplier | 4600 Little Blue Pkwy, Independence, MO 64057-8302 | 2005-07-21 |
| 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 |
| 1437783776 | Mager & Gougelman of St. Louis, LLC | Prosthetic/Orthotic Supplier | 1034 S Brentwood Blvd Ste 1880, Richmond Heights, MO 63117-1218 | 2020-02-25 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | INDEPENDENCE |
| Zip Code | 64055 |
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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.