Frontier Integrated Health Center Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

112431 Issued in MO

Legal business name

FRONTIER INTEGRATED HEALTH CENTER INC

Practice address

199 Frontier Park Dr
O Fallon, MO 63366-3963

Phone

(636) 379-5934

Fax

(636) 410-3323

NPI assigned

Jun 11, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Raymond James Ottomeyer III, DCNPI 1134235799

Title

Owner

Phone

(636) 379-5934

Specialties & licenses 3

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raymond James Ottomeyer III, D.C.

  • Chiropractor
  • O'Fallon, MO
  • NPI 1134235799
  Medicare reassignment NPD Authorized official
• Scott Derek Mathys, P.T

  • Physical Therapist
  • O'Fallon, MO
  • NPI 1134228059
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1114120649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 FRONTIER PARK DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633663963",
            "telephone_number": "636-379-5934",
            "fax_number": "636-410-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 FRONTIER PARK DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633663963",
            "telephone_number": "636-379-5934",
            "fax_number": "636-410-3323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRONTIER INTEGRATED HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A",
        "authorized_official_last_name": "OTTOMEYER",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-379-5934",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MO",
            "license": "112431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS",
            "identifier": "160876",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2576722",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "375245",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drottomeyer@frontierhealthcenter.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "199 Frontier Park Dr",
            "city": "O Fallon",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633663963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Friedrichs Physical Therapy, LLC (Spirit Physical Therapy)
• David Friedrichs, DPT, CMPT
• Erin Friesen
• Jennifer Frieswick
• Eric Joseph Fritsche
• Michelle Fruend
• Amanda Fullerton, MOT, OTR/L
• Janusz Marek Furman, PT
• Brandon Gabler, DC
• Louis Gaefke, DPM

• Clinic/Center in O'Fallon, MO
• Providers in O'Fallon, MO by specialty
• Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.