Mager & Gougelman of St. Louis, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

MAGER & GOUGELMAN OF ST. LOUIS, LLC

Practice address

1034 S Brentwood Blvd Ste 1880
Richmond Heights, MO 63117-1218

Phone

(314) 726-1818

Fax

(314) 726-0295

NPI assigned

Feb 25, 2020

Last updated

Feb 25, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Todd Michael Chiles, BCO, BADO

Title

Owner

Phone

(314) 726-1818

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1582588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582588800000",
    "number": "1437783776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 S BRENTWOOD BLVD STE 1880",
            "city": "RICHMOND HEIGHTS",
            "state": "MO",
            "postal_code": "631171218",
            "telephone_number": "314-726-1818",
            "fax_number": "314-726-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 S BRENTWOOD BLVD STE 1880",
            "city": "RICHMOND HEIGHTS",
            "state": "MO",
            "postal_code": "631171218",
            "telephone_number": "314-726-1818",
            "fax_number": "314-726-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGER & GOUGELMAN OF ST. LOUIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-25",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A",
        "authorized_official_last_name": "CHILES",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-726-1818",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BCO, BADO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Richmond Heights, MO
• Providers in Richmond Heights, MO by specialty
• Prosthetic/Orthotic Supplier in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.