Organization Active NPI

Alpha-Omega Orthotics & Prosthetics, Inc.

  • Prosthetic/Orthotic Supplier
  • Springfield, MO
National Provider Identifier
1679684013
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
ALPHA-OMEGA ORTHOTICS & PROSTHETICS, INC.
Practice address
2021 S Waverly Ave Ste 300
Springfield, MO 65804-2417
Phone
(417) 886-8881
Fax
(417) 881-8223
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Ronald A 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 connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

2021 S Waverly Ave Ste 300
Springfield, MO 65804-2417

Mailing address

2021 S Waverly Ave Ste 300
Springfield, MO 65804-2417
Phone (417) 886-8881

Other identifiers 1

IdentifierTypeStateIssuer
31440OtherMOBLUECROSS BLUESHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930053142 MO DME Supplier - Orthotic PersonnelDME Supplier - Medical Supply Company With Orthotic-ProstheticDME Supplier - Prosthetic Personnel 7113047515 Practice locations: Springfield, MO

Other NPIs with the same Medicare PAC ID 2

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

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Alpha-Omega Orthotics & Prosthetics2021 S Waverly Ave, Springfield, MO 65804-2417(417) 886-8881 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

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

Other organizations with this tax ID 2

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

Locations

308 N Kentucky Ave
Ste 4
West Plains, MO 65775
Phone (417) 257-7411

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679684013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 S WAVERLY AVE STE 300",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042417",
            "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": "2021 S WAVERLY AVE STE 300",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042417",
            "telephone_number": "417-886-8881",
            "fax_number": "417-881-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPHA-OMEGA ORTHOTICS & PROSTHETICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VAHL",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "A",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "31440",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.