Michael'S Orthotics, L.L.C.

Primary specialty

Prosthetics Case ManagementTaxonomy code 1744P3200X

License

330348306 Issued in MO

Legal business name

MICHAEL'S ORTHOTICS, L.L.C.

Practice address

1551 Classen Dr
Belleville, IL 62220-3260

Phone

(314) 532-5462

NPI assigned

Apr 10, 2015

Organization subpart

No

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

Authorized official

Name

Mr. T. Michael Kukowsky, C. PED.

Title

Certified Pedorthists

Phone

(314) 532-5462

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428624000000",
    "number": "1245626720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S MERAMEC AVE",
            "address_2": "SUITE306",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631053511",
            "telephone_number": "314-532-5462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 CLASSEN DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622203260",
            "telephone_number": "314-532-5462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL'S ORTHOTICS, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-10",
        "last_updated": "2015-04-10",
        "status": "A",
        "authorized_official_last_name": "KUKOWSKY",
        "authorized_official_first_name": "T.",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CERTIFIED PEDORTHISTS",
        "authorized_official_telephone_number": "314-532-5462",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "C. PED."
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "MO",
            "license": "330348306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetics Case Management in Belleville, IL
• Providers in Belleville, IL by specialty
• Prosthetics Case Management in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2015; 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.