BLUETAIL MEDICAL GROUP, LLC. (NPI# 1285986398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285986398 |
| Entity Type | Organization |
| Organization Name | BLUETAIL MEDICAL GROUP, LLC. |
| Practice Address |
17300 N Outer 40 Rd Suite 201 Chesterfield MO 63005-1375 |
| Mailing Address |
Po Box 11665 Belfast ME 04915-4007 |
| Practice Telephone | 6367782900 |
| Practice Fax Number | 6367782828 |
| Mailing Telephone | 6367782900 |
| Mailing Fax Number | 6367782828 |
| Enumeration Date | 2012-10-12 |
| Last Update Date | 2018-03-20 |
| Authorized Official Name | DR. KRISTEN OLIVER (OWNER) |
| Authorized Official Telephone | 6367782900 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
LC1262307 | MO | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1201 Piper Blvd Ste 25, Naples, FL 341101385 | 2396311960 | 2396315967 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942541610 | Bluetail Medical Group, LLC. | Orthopaedic Surgery | 1410 Forum Katy Pkwy, Ste. 100, Columbia, MO 65203-6325 | 2013-03-06 |
| Street Address |
17300 N OUTER 40 RD SUITE 201 |
| City | CHESTERFIELD |
| State | MO |
| Zip Code | 63005-1375 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396728002 | Matthew Christian Bayes | Pediatrics | 17300 N Outer 40 Rd, Suite 201, Chesterfield, MO 63005-1364 | 2005-11-28 |
| 1467073742 | Key Anesthesia Partners | Nurse Anesthetist, Certified Registered | 17300 N Outer 40 Rd, Chesterfield, MO 63005-1375 | 2020-04-28 |
| 1578917126 | Jessica Aschwege | Physical Therapist | 17300 N Outer 40 Rd, Suite 202, Chesterfield, MO 63005-1375 | 2016-04-20 |
| 1659784023 | Natalie Corzine | Behavioral Analyst | 17300 N Outer 40 Rd, Chesterfield, MO 63005-1364 | 2014-06-03 |
| 1891114526 | Michael V Oliveri | Clinical Neuropsychologist | 17300 N Outer 40 Rd, Suite 203, Chesterfield, MO 63005-1364 | 2014-04-09 |
| 1487076485 | Missouri Center for Reproductive Medicine, LLC | Obstetrics & Gynecology | 17300 N Outer 40 Rd, Suite 101, Chesterfield, MO 63005-1364 | 2014-01-09 |
| 1639500192 | Pediatric Neurodevelopmental Center LLC | Pediatrics | 17300 N Outer 40 Rd, Suite 205, Chesterfield, MO 63005-1364 | 2013-12-10 |
| 1821423385 | Excel Orthopedics LLC | Orthopaedic Surgery | 17300 N Outer 40 Rd, Suite 316, Chesterfield, MO 63005-1375 | 2013-09-03 |
| 1427315431 | Michael Joseph Backer | Student in an Organized Health Care Education/Training Program | 17300 N Outer 40 Rd, Suite 103, Chesterfield, MO 63005-1375 | 2012-04-15 |
| 1154622926 | Erin Berkow Seltzer | Counselor | 17300 N Outer 40 Rd, Suite 212, Chesterfield, MO 63005-1364 | 2010-11-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063901254 | Ryan Hewkin | Chiropractor | 17684 Chesterfield Airport Road, Chesterfield, MO 63005 | 2018-05-03 |
| 1093224487 | All Family Matters, LLC | In Home Supportive Care | 100 Chesterfield Business Pkwy Ste 200, Chesterfield, MO 63005 | 2017-09-28 |
| 1437681293 | Emily Therese Harpel | Pharmacist | 691 Trade Center Blvd, Chesterfield, MO 63005 | 2017-03-31 |
| 1831543826 | Leslie Noel Chanasue | Family Medicine | 17701 Edison Ave Ste 101, Chesterfield, MO 63005 | 2016-04-16 |
| 1497112874 | Jordan Kimler | Nurse Practitioner | 124 Chesterfield Towne Ctr, Chesterfield, MO 63005 | 2016-01-15 |
| 1265850556 | Richard George Rougeau | General Practice | 17679 Wildridge Drive, Wildwood, MO 63005 | 2014-04-03 |
| 1679912554 | Ceara M Barmeier | Physician Assistant | 17300 N Outer 40 Rd #101, Chesterfield, MO 63005 | 2013-06-24 |
| 1265794911 | Regeneration Orthopedics, LLC | Anesthesiology | 6 Mcbride & Son Center Dr., Ste 204, Chesterfield, MO 63005 | 2012-06-08 |
| 1528334984 | Syed Tanveer Haider | Radiologic Technologist | 16502 Barrister Lane, Chesterfield, MO 63005 | 2012-03-29 |
| 1144591041 | Sensible Dental - Chesterfield | Dentist | 100 Thf Blvd., Chesterfield, MO 63005 | 2012-01-24 |
| Find all providers in zip 63005 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033326137 | Luke S Choi | Orthopaedic Surgery | 14285 N. Outer Forty Rd, Suite 200, Chesterfield, MO 63195-0000 | 2007-05-17 |
| 1467533372 | Gpaletta Orthopedic Consulting, LLC | Orthopaedic Surgery | 14825 S. Outer Forty Rd, Suite 200, Chesterfield, MO 63017 | 2006-10-18 |
| 1497726566 | Crane Clinic for Sports Performance | Orthopaedic Surgery | 219 Chesterfield Towne Ctr, Chesterfield, MO 63005-1257 | 2006-01-27 |
| 1598783227 | Mark Edward Halstead | Orthopaedic Surgery | 14532 S Outer 40 Rd, Ste 200, Chesterfield, MO 63017-5705 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184018632 | Christopher Amundsen | Orthopaedic Surgery | 448 State Highway 248, Branson, MO 65616 | 2015-03-23 |
| 1134344922 | Scott Geoffrey Kaar | Orthopaedic Surgery | U21 S. New Ballas Rd, Ste 3005 B, St Louis, MO 63141 | 2007-04-16 |
| 1013015106 | Allen G Adams | Orthopaedic Surgery | 904 Edmond St, Saint Joseph, MO 64501-2702 | 2006-09-20 |
| 1891728051 | Jody T Jachna | Orthopaedic Surgery | 400 1st Capitol Dr Ste 100, Saint Charles, MO 63301-2881 | 2006-07-09 |
| 1487623260 | Douglas W Kiburz | Orthopaedic Surgery | 2301 S Ingram Ave, Sedalia, MO 65301-8121 | 2006-03-15 |
| 1124009212 | Christopher M Miller | Orthopaedic Surgery | 3555 S National Ave, Springfield, MO 65807-7310 | 2005-11-07 |
| 1255958138 | Gina Marie Fasano | Orthopaedic Surgery | 54 Hospital Dr, Osage Beach, MO 65065-3050 | 2020-06-26 |
| 1144768912 | Joint Health LLC | Orthopaedic Surgery | 633 Emerson Rd, Suite 10, Creve Coeur, MO 63141-6739 | 2017-02-01 |
| 1487107736 | Betina Hinckel | Orthopaedic Surgery | 1100 Virginia Ave Rm 4056, Columbia, MO 65212-0001 | 2016-08-03 |
| 1952773533 | Kansas City Center for Hip Preservation and Sports Medicine | Orthopaedic Surgery | 6100 Timberidge, Parkville, MO 64152-6099 | 2015-10-22 |
| Find all providers with the same taxonomy | ||||
| City | CHESTERFIELD |
| Zip Code | 63005 |
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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.