Active NPI
David R. Lange, MD
- Orthopaedic Surgery Physician
- Saint Louis, MO
National Provider Identifier
1154316784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- R6388
- Practice address
- 12855 North Forty Drive
Suite 125, North Tower
Saint Louis, MO 63141 - Phone
- (314) 966-0111
- Fax
- (314) 966-1023
- NPI assigned
- Sep 20, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | R6388 | MO | Primary |
| Orthopaedic Surgery of the Spine Physician | 207XS0117X | R6388 | MO |
Addresses
Primary practice location
12855 North Forty Drive
Suite 125, North Tower
Saint Louis, MO 63141
Mailing address
12813 Flushing Meadows Drive
Suite 210
St. Louis, MO 63131
Phone (314) 966-0111
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R6388 | MO | MD | Orthopaedic Surgery of the Spine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321488000000",
"number": "1154316784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12813 FLUSHING MEADOWS DRIVE",
"address_2": "SUITE 210",
"city": "ST. LOUIS",
"state": "MO",
"postal_code": "63131",
"telephone_number": "314-966-0111",
"fax_number": "314-966-1023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12855 NORTH FORTY DRIVE",
"address_2": "SUITE 125, NORTH TOWER",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "63141",
"telephone_number": "314-966-0111",
"fax_number": "314-966-1023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANGE",
"first_name": "DAVID",
"middle_name": "R.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-20",
"last_updated": "2011-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "MO",
"license": "R6388",
"primary": true
},
{
"code": "207XS0117X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
"state": "MO",
"license": "R6388",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.