Bluetail Biologics LLC

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

Legal business name

BLUETAIL BIOLOGICS LLC

Practice address

17300 N Outer 40 Rd Ste 201
Chesterfield, MO 63005-1364

Phone

(636) 778-2900

Fax

(636) 778-2828

NPI assigned

Oct 23, 2018

Last updated

Oct 23, 2018By 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

Joe Oneil

Title

Practice Administrator

Phone

(636) 778-2826

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540252800000",
    "number": "1639645070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17300 N OUTER 40 RD STE 201",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051364",
            "telephone_number": "636-778-2900",
            "fax_number": "636-778-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17300 N OUTER 40 RD STE 201",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051364",
            "telephone_number": "636-778-2900",
            "fax_number": "636-778-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUETAIL BIOLOGICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-23",
        "last_updated": "2018-10-23",
        "status": "A",
        "authorized_official_last_name": "ONEIL",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "636-778-2826"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Blanzy, MSN, APRN, FNP-BC
• Susan Akers Blattel, MD
• Blink Health Pharmacy LLC
• Sarah Elizabeth Bloch, RN, MSN, FNP
• Amy Louise Bloomfield, PA
• Bluetail Medical Group, LLC.
• Atrall Bobenhouse, M.A., CCC-SLP
• Evgenii Bobrikov, MD
• Leanne Marie Bockstruck, PHARM.D.
• Jeffrey L. Boesch, M.D.

• Sports Medicine (Family Medicine) Physician in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Sports Medicine (Family Medicine) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; 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.