Active NPI
Bi-State Orthotics and Prosthetics
- Prosthetic/Orthotic Supplier
- Saint Louis, MO
National Provider Identifier
1487816583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154462950 | Medicaid | MO |
National Provider Directory
National Provider Directory- Tax ID family
- Bi-State Orthotics and Prosthetics
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Prosthetic/Orthotic Supplier
- Belleville, IL
- NPI 1154462950
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.