LAKE ST. LOUIS WIGS AND CUTS (NPI# 1659987295) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659987295 |
| Entity Type | Organization |
| Organization Name | LAKE ST. LOUIS WIGS AND CUTS |
| Practice Address |
950 Corporate Pkwy Ste 100 Wentzville MO 63385-4851 |
| Practice Telephone | 6368872193 |
| Mailing Telephone | 6368872193 |
| Enumeration Date | 2020-09-18 |
| Last Update Date | 2020-09-18 |
| Authorized Official Name | SUSAN HOUSEWRIGHT (PRESIDENT) |
| Authorized Official Telephone | 6368872193 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224P00000X | Prosthetist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
950 CORPORATE PKWY STE 100 |
| City | WENTZVILLE |
| State | MO |
| Zip Code | 63385-4851 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730243 | Jeffery William Ellis | Pharmacist | 1571 Wentzville Parkway, Wentzville, MO 63385 | 2020-11-05 |
| 1487266011 | Jason Wade Moore | Peer Specialist | 5 West Pearce Boulevard, Wentzville, MO 63385 | 2020-08-17 |
| 1265906176 | Montrice M Haynes | Counselor | 500 Medical Dr., Central Intake, Wentzville, MO 63385 | 2019-01-14 |
| 1841718459 | Linda Duree | Counselor | 7105 Whisper Creek Dr, Wentzville, MO 63385 | 2017-09-03 |
| 1811349368 | Sara Kleinlein | Social Worker | 500 Medical Drive, Wentzville, MO 63385 | 2016-07-08 |
| 1275980757 | Teona Moeller | Nurse Practitioner | 1598 West Meyer Dr., Wentzville, MO 63385 | 2016-05-16 |
| 1831561273 | Jay F. Hauser, Dds, PC | Dentist | 11 Wentzville Bluffs Drive, Wentzville, MO 63385 | 2015-10-26 |
| 1720402035 | Shara Kuehl | Speech-Language Pathologist | One Campus Drive, Wentzville, MO 63385 | 2014-02-06 |
| 1336480474 | Simply Loyal In Home and Transport Services LLC | Home Health | 152 Enterprise Dr, Wentzille, MO 63385 | 2013-03-14 |
| 1750641338 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 1849 Wentzville Parkway, Wentzville, MO 63385 | 2012-05-17 |
| Find all providers in zip 63385 | ||||
| Taxonomy Code | 224P00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Prosthetist |
| A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| 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 |
|---|---|---|---|---|
| 1093320962 | Nia L Taylor | Prosthetist | 411 Sw Ward Rd, Lees Summit, MO 64081-2448 | 2020-09-09 |
| 1053926964 | Deann Porter | Prosthetist | 8743 Mavis Place, St Louis, MO 63114 | 2020-09-09 |
| 1417458662 | Whitney Marie Witherspoon | Prosthetist | 3821 Vaile Ave, Florissant, MO 63034-2227 | 2018-02-23 |
| 1053657924 | Jazz Hair Institute | Prosthetist | 3950 Cook Ave, Saint Louis, MO 63113-3402 | 2012-12-21 |
| 1932445095 | Tamera Newberry | Prosthetist | 5248 Darkmoor Ln, Imperial, MO 63052-3036 | 2012-12-18 |
| 1972803773 | Frank T Coppolino Jr. | Prosthetist | 5425 Regency Woods Mnr, Imperial, MO 63052-1971 | 2010-10-26 |
| 1649507328 | Vikram Choudhary | Prosthetist | 6126 Washington Blvd, # 201, St. Louis, MO 63112 | 2009-11-17 |
| 1326197559 | Karen Christine Reiff | Prosthetist | 3230 S National Ave, Suite B, Springfield, MO 65807-7303 | 2007-01-09 |
| 1548348451 | Catherine S Sorrel I | Prosthetist | 41 State Road O Apt 1a, Macks Creek, MO 65786-9500 | 2006-11-01 |
| 1134110893 | Roberta J Peregrine | Prosthetist | 2602 Frederick Ave, Ste A, Saint Joseph, MO 64506-2840 | 2005-11-02 |
| Find all providers with the same taxonomy | ||||
| City | WENTZVILLE |
| Zip Code | 63385 |
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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.