Individual provider Active NPI

Ronald A Vahl, CPO

  • Prosthetics Case Management
  • Springfield, MO
National Provider Identifier
1124136890
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
License
02674 Issued in MO
Practice address
2021 S Waverly Ave Ste 300
Springfield, MO 65804-2417
Phone
(417) 886-8881
NPI assigned
Aug 25, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case Management 1744P3200X 02674 MO Primary

Addresses

Primary practice location

2021 S Waverly Ave Ste 300
Springfield, MO 65804-2417

Mailing address

2021 S Waverly Ave Ste 300
Springfield, MO 65804-2417
Phone (417) 886-8881

Other identifiers 1

IdentifierTypeStateIssuer
31440OtherMOBLUECROSS BLUESHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
02674MOMDProsthetics Case Management

Practice roles

OrganizationSpecialtyStatusNew patients
Alpha-Omega Orthotics & Prosthetics, Inc. Past Accepting new patients
Alpha-Omega Orthotics & Prosthetics, Inc. Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1124136890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 S WAVERLY AVE STE 300",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042417",
            "telephone_number": "417-886-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 S WAVERLY AVE STE 300",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042417",
            "telephone_number": "417-886-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAHL",
        "first_name": "RONALD",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "CPO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "MO",
            "license": "02674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "31440",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.