Organization Active NPI

Bi-State Orthotics and Prosthetics

  • Prosthetic/Orthotic Supplier
  • Saint Louis, MO
National Provider Identifier
1487816583
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
BI-STATE ORTHOTICS AND PROSTHETICS
Practice address
12660 Lamplighter SQR Shppng Ctr
Suite J
Saint Louis, MO 63128-2761
Phone
(314) 843-2664
NPI assigned
Jun 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
Mr. Thomas J Nieder Sr., COF
Title
President
Phone
(314) 843-2664

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

12660 Lamplighter SQR Shppng Ctr
Suite J
Saint Louis, MO 63128-2761

Mailing address

12660 Lamplighter SQR Shppng Ctr
Suite J
Saint Louis, MO 63128-2761

Other identifiers 1

IdentifierTypeStateIssuer
1154462950MedicaidMO

National Provider Directory

National Provider Directory
Tax ID family
Bi-State Orthotics and Prosthetics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12660 Lamplighter Square Shpg Ctr
Ste J
Saint Louis, MO 63128
Phone (314) 394-1379

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1487816583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12660 LAMPLIGHTER SQR SHPPNG CTR",
            "address_2": "SUITE J",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12660 LAMPLIGHTER SQR SHPPNG CTR",
            "address_2": "SUITE J",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282761",
            "telephone_number": "314-843-2664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BI-STATE ORTHOTICS AND PROSTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "NIEDER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-843-2664",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "COF"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154462950",
            "state": "MO"
        }
    ],
    "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 Jun 30, 2008; 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.