BI-STATE ORTHOTICS AND PROSTHETICS (NPI# 1487816583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487816583 |
| Entity Type | Organization |
| Organization Name | BI-STATE ORTHOTICS AND PROSTHETICS |
| Practice Address |
12660 Lamplighter Sqr Shppng Ctr Suite J Saint Louis MO 63128-2761 |
| Practice Telephone | 3148432664 |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2008-06-30 |
| Authorized Official Name | MR. THOMAS J NIEDER SR. (PRESIDENT) |
| Authorized Official Telephone | 3148432664 |
| Authorized Official Credential | COF |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1154462950 | 05 |
| Street Address |
12660 LAMPLIGHTER SQR SHPPNG CTR SUITE J |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63128-2761 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578866596 | Misty Dawn Birney | Nurse Practitioner | 12660 Lamplighter Sqr Shppng Ctr, Suite J, Saint Louis, MO 63128-2761 | 2010-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235771155 | James T Fetsch Dmd LLC | Dentist | 10004 Kennerly Rd Suite 240, Saint Louis, MO 63128 | 2019-10-11 |
| 1326504655 | Nikodem Dental Holdings | Dentist | 4337 Butler Hill Rd Suite G, St Louis Mo, MO 63128 | 2019-02-12 |
| 1932678505 | Michelle Anne Arvidson | Physical Therapy Assistant | Elite Physical Therapy, 12608 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2018-11-13 |
| 1245726710 | Kristen Rider | Nurse Practitioner | 9964 Kennerly Rd Ste D, Saint Louis, MO 63128 | 2018-07-07 |
| 1306217427 | Sophia Bednarski | Dentist | 12660 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2015-10-15 |
| 1427434224 | Darcie Burrus | Counselor | 12523 Old Tesson Rd G, St Louis, MO 63128 | 2015-08-04 |
| 1710368584 | Sara Hawatmeh | Internal Medicine | 12345 W Bend Dr Ste 304, Saint Louis, MO 63128 | 2015-06-17 |
| 1871989590 | Celia Grace Montes-kolence | Speech-Language Pathologist | 12335 W Bend Drive, Saint Louis, MO 63128 | 2015-04-09 |
| 1245629302 | Marius Antonio Evans | Dentist | 9911 Kennerly Rd., Suite G, St. Louis, MO 63128 | 2015-01-13 |
| 1801230313 | Sarah Elizabeth Walsh | Emergency Medicine | 10010 Kennerly Road, Emergency Department, St. Anthony's Medical Center, St. Louis, MO 63128 | 2013-04-26 |
| Find all providers in zip 63128 | ||||
| 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 |
| 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 |
| 1689672750 | Prosthetic Design, Inc. | Prosthetic/Orthotic Supplier | 5467 Highland Park Dr, Saint Louis, MO 63110-1313 | 2005-07-12 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63128 |
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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.