OPTIMAL HEALTH OF MO, LLC


Address: 11628 Old Ballas Rd # 345, Saint Louis, MO 63141-7030
Phone: 6153860064

OPTIMAL HEALTH OF MO, LLC (NPI# 1881193894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1881193894
Entity Type Organization
Organization Name OPTIMAL HEALTH OF MO, LLC
Practice Address 11628 Old Ballas Rd # 345
Saint Louis
MO 63141-7030
Mailing Address 102 Woodmont Blvd Ste 350
Nashville
TN 37205-2216
Practice Telephone 6153860064
Practice Fax Number 6153860067
Mailing Telephone 6153860064
Mailing Fax Number 6153860067
Enumeration Date 2018-02-05
Last Update Date 2020-02-13
Authorized Official Name EDWARD LELAND HUTTON EADIE (DIRECTOR)
Authorized Official Telephone 6157332064
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207XS0117X Orthopaedic Surgery
Specialization: Orthopaedic Surgery of the Spine
MO Allopathic & Osteopathic Physicians
Y 207X00000X Orthopaedic Surgery MO Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
10010 Kennerly Rd, Saint Louis, MO 631282106 6153860064 6153860067

Office Location

Street Address 11628 OLD BALLAS RD # 345
City SAINT LOUIS
State MO
Zip Code 63141-7030

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1679102842 Noor Ramadan Pharmacist 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 2020-04-08
1497381206 Washington University Durable Medical Equipment & Medical Supplies 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 2020-03-13
1154956498 Ashleigh Clendenny Physician Assistant Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 2020-03-06
1801429410 Emili Lou Haley Registered Nurse 650 Maryville Drive, St Louis, MO 63141 2020-02-21
1629553110 Rebecca Kathleen Pike Social Worker West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 2018-10-01
1649756099 River City Sedation Associates, LLC Nurse Anesthetist, Certified Registered 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 2018-07-18
1205333952 Ear Care and Hearing of St. Louis Hearing Aid Equipment 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 2018-04-10
1659897486 Erin Goodman Physical Therapist 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 2017-08-14
1093230450 Center for Urologic Surgery LLC Clinic/Center 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 2017-08-07
1871016105 Jacob Farley Tanner Specialist/Technologist 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 2017-07-19
Find all providers in zip 63141

Taxonomy Information

Taxonomy Code 207X00000X
Grouping Allopathic & Osteopathic Physicians
Classification Orthopaedic Surgery

Taxonomy Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1760903850 Adam J Martin Orthopaedic Surgery 621 S New Ballas Rd Ste 3005b, Saint Louis, MO 63141-8266 2017-06-29
1801254164 St. Anthony's Physician Organization Orthopaedic Surgery 12700 Southfork Rd Ste 100, Saint Louis, MO 63128-3201 2016-02-02
1285051482 Michael Joseph Reiter Orthopaedic Surgery 3009 N Ballas Rd Ste 269c, Saint Louis, MO 63131-2339 2014-03-25
1154767507 Robert M Corey Orthopaedic Surgery 3635 Vista Ave, 7th Floor- Desloge Tower, Department of Orthopedics, Saint Louis, MO 63110 2013-05-13
1770855884 George Owens Sertl Orthopaedic Surgery 10757 Forest Path Dr, Saint Louis, MO 63128-2008 2012-02-04
1285881581 John Powell Arnot Orthopaedic Surgery 1145 Lockett Rd, Saint Louis, MO 63131-4234 2008-08-19
1558526327 Jordan Howard Ginsburg Orthopaedic Surgery 231 S Bemiston Ave, Suite 500, Saint Louis, MO 63105-1914 2008-07-22
1659562528 Kenyatta D Norman Orthopaedic Surgery 1209 Washington Ave, Ste 518, Saint Louis, MO 63103-1996 2007-08-06
1134342918 Matthew Walter Bradley Orthopaedic Surgery 1001 S Kirkwood Rd Ste 120, Saint Louis, MO 63122-7250 2007-04-10
1437272663 St. Louis-clayton Orthopedic Group, Inc. Orthopaedic Surgery 1034 S Brentwood Blvd Ste 650, Saint Louis, MO 63117-1267 2007-04-10
Find all providers in SAINT LOUIS

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City SAINT LOUIS
Zip Code 63141

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Dataset Information

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.

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