Petkovich Orthopedic and Spine Care LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

R5882 Issued in MO

Legal business name

PETKOVICH ORTHOPEDIC AND SPINE CARE LLC

Practice address

2821 N Ballas Rd
Suite C 70
Saint Louis, MO 63131-2321

Phone

(314) 432-6500

NPI assigned

Oct 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Frank Ogden Petkovich, MDNPI 1609827070

Title

Doctor

Phone

(314) 432-6500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

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

• Frank O Petkovich, M.D.

  • Orthopaedic Surgery Physician
  • Saint Louis, MO
  • NPI 1609827070
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715040000000",
    "number": "1861680316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2821 N BALLAS RD",
            "address_2": "SUITE C 70",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312321",
            "telephone_number": "314-432-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 N BALLAS RD",
            "address_2": "SUITE C 70",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312321",
            "telephone_number": "314-432-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETKOVICH ORTHOPEDIC AND SPINE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-10",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A",
        "authorized_official_last_name": "PETKOVICH",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "OGDEN",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "314-432-6500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "R5882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Scott Peterson, CRNA
• Renuka E Peterson, M.D.
• Tayler Pearl Peterson, DO
• Tiffany L Peterson, LCP
• Zoe D. Peterson, PH.D.
• Bradley William Petkovich, M.D.
• Frank O Petkovich, M.D.
• Peggy A Petralia, D.O.
• Michael Joseph Petrany
• Kelly Petrash

• Orthopaedic Surgery Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Orthopaedic Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.