ORTHOTIC AND PROSTHETIC LAB, INC (NPI# 1558422402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558422402 |
| Entity Type | Organization |
| Organization Name | ORTHOTIC AND PROSTHETIC LAB, INC |
| Practice Address |
101 Olympic Way Saint Peters MO 63376-1664 |
| Mailing Address |
748 Marshall Ave Saint Louis MO 63119-1924 |
| Practice Telephone | 6364416400 |
| Mailing Telephone | 3149688555 |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2017-02-14 |
| Authorized Official Name | MR. DAVID J OSTERMAN (OWNER) |
| Authorized Official Telephone | 3149688555 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 335E00000X | Prosthetic/Orthotic Supplier | 211.000024 | IL | Suppliers |
| Y | 335E00000X | Prosthetic/Orthotic Supplier | 213.000099 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 621818608 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265593115 | Orthotic and Prosthetic Lab, Inc | Durable Medical Equipment & Medical Supplies | 4921 Parkview Pl, Suite 13d, Saint Louis, MO 63110-1032 | 2006-12-13 |
| 1649331596 | Orthotic and Prosthetic Lab, Inc | Durable Medical Equipment & Medical Supplies | 845 North New Ballas Court, Suite 320, Creve Coeur, MO 63141-7169 | 2006-12-13 |
| Street Address |
101 OLYMPIC WAY |
| City | SAINT PETERS |
| State | MO |
| Zip Code | 63376-1664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902453764 | Medcuro Manufacturing, LLC | Prosthetic/Orthotic Supplier | 101 Olympic Way, Saint Peters, MO 63376-1664 | 2019-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275047946 | Nicholas Christian Schultz | Dentist | 100 Piper Hill Dr Ste A, Saint Peters, MO 63376 | 2017-11-16 |
| 1982120093 | Carol Weber | Speech-Language Pathologist | 166 Boone Hills Dr., St Peters, MO 63376 | 2017-08-21 |
| 1619424744 | Forefront Dermatology, S.c. | Dermatology | 5700 Mexico Rd, Suite 14, Saint Peters, MO 63376 | 2016-09-07 |
| 1508310632 | Preferred Family Healthcare, Inc. | Counselor | 2120 Parkway Dr, Saint Peters, MO 63376 | 2016-08-05 |
| 1598130676 | Delta Center Personal Attendant Services | In Home Supportive Care | 3833 Mcclay, Suite 61, St. Peters, MO 63376 | 2015-12-01 |
| 1427420314 | Barbara Marlene Edelman | Counselor | 1286 Jungerman Rd. Suite G, St. Peters, MO 63376 | 2015-10-30 |
| 1255740247 | Claire Williams | Dentist | 340 Mid Rivers Mall Drive, Suite E, St. Peters, MO 63376 | 2014-08-05 |
| 1184042855 | Keith Wickenhauser | Internal Medicine | 201 Bjc Saint Peters Dr Ste 100, Saint Peters, MO 63376 | 2014-03-31 |
| 1821415233 | Abby Link | Physician Assistant | 107 Piper Parkway, #150, St. Peters, MO 63376 | 2014-03-24 |
| 1225452105 | Ashley Gagel | Physical Therapist | 7055 Mexico Rd Suite 1601, St. Peters, MO 63376 | 2014-02-12 |
| Find all providers in zip 63376 | ||||
| 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 |
|---|---|---|---|---|
| 1902453764 | Medcuro Manufacturing, LLC | Prosthetic/Orthotic Supplier | 101 Olympic Way, Saint Peters, MO 63376-1664 | 2019-08-26 |
| 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 | SAINT PETERS |
| Zip Code | 63376 |
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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.