NPIMap

Organization Active NPI

Alpha-Omega Orthotics & Prosthetics, Inc.

  • Prosthetic/Orthotic Supplier
  • Bolivar, MO
National Provider Identifier
1588085278
Registry record updated Jul 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
BUS-0027960 Issued in MO
Legal business name
ALPHA-OMEGA ORTHOTICS & PROSTHETICS, INC.
Practice address
785 E Drake St
Bolivar, MO 65613-2739
Phone
(417) 886-8881
Fax
(417) 881-8223
NPI assigned
Dec 23, 2013
Last updated
Jul 23, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
ALPHA-OMEGA ORTHOTICS & PROSTHETICS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 23, 2014

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

Authorized official

Name
Mr. Ronald Vahl, CPONPI 1124136890
Title
President
Phone
(417) 886-8881

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X BUS-0027960 MO Primary

Addresses

Primary practice location

785 E Drake St
Bolivar, MO 65613-2739

Mailing address

2021 S Waverly Ave
Suite 300
Springfield, MO 65804-2414
Phone (417) 886-8881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140527001456 MO DME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 7113047515 Practice locations: Bolivar, MO

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Alpha-Omega Orthotics Prosthetics Inc3 organizations share this tax ID, including this one
Part of
Alpha-Omega Orthotics Prosthetics Inc

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1387756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406073600000",
    "number": "1588085278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 S WAVERLY AVE",
            "address_2": "SUITE 300",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042414",
            "telephone_number": "417-886-8881",
            "fax_number": "417-881-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 E DRAKE ST",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656132739",
            "telephone_number": "417-886-8881",
            "fax_number": "417-881-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPHA-OMEGA ORTHOTICS & PROSTHETICS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALPHA-OMEGA ORTHOTICS & PROSTHETICS, INC.",
        "enumeration_date": "2013-12-23",
        "last_updated": "2014-07-23",
        "status": "A",
        "authorized_official_last_name": "VAHL",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "417-886-8881",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "MO",
            "license": "BUS-0027960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivar, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.