Active NPI
Ronald A Vahl, CPO
- Prosthetics Case Management
- Springfield, MO
National Provider Identifier
1124136890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetics Case Management
- License
- 02674
- 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, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31440 | Other | MO | BLUECROSS 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
| License | State | Type | Specialty |
|---|---|---|---|
| 02674 | MO | MD | Prosthetics Case Management |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Prosthetic/Orthotic Supplier
- Bolivar, MO
- NPI 1588085278
-
- Prosthetic/Orthotic Supplier
- Springfield, MO
- NPI 1679684013
-
- Prosthetic/Orthotic Supplier
- West Plains, MO
- NPI 1780781922
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.