Organization Active NPI

Midwest Illinois Orthotics LLC

  • Customized Equipment (DME)
  • Maryland Heights, MO
National Provider Identifier
1174968820
Registry record updated Aug 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
MIDWEST ILLINOIS ORTHOTICS LLC
Practice address
11425 Dorsett Rd
Ste B
Maryland Heights, MO 63043-3445
Phone
(314) 739-4408
Fax
(888) 770-2935
NPI assigned
May 8, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2013

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

Authorized official

Name
Dr. Don Havey
Title
Director
Phone
(314) 821-2600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X Primary

Addresses

Primary practice location

11425 Dorsett Rd
Ste B
Maryland Heights, MO 63043-3445

Mailing address

12166 Old Big Bend Rd
Ste 303
Kirkwood, MO 63122-6844
Phone (314) 821-2600

National Provider Directory

National Provider Directory

Locations

17600 Chesterfield Airport Rd
Ste 204
Chesterfield, MO 63005

11425 Dorsett Rd
Ste B
Maryland Heights, MO 63043
Phone (314) 739-4408

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1367971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375747200000",
    "number": "1174968820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12166 OLD BIG BEND RD",
            "address_2": "STE 303",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631226844",
            "telephone_number": "314-821-2600",
            "fax_number": "888-770-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11425 DORSETT RD",
            "address_2": "STE B",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630433445",
            "telephone_number": "314-739-4408",
            "fax_number": "888-770-2935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST ILLINOIS ORTHOTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-08",
        "last_updated": "2013-08-06",
        "status": "A",
        "authorized_official_last_name": "HAVEY",
        "authorized_official_first_name": "DON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "314-821-2600",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryland Heights, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2013; 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.