NPIMap

Organization Active NPI

St Louis Orthopedic Institute Inc

  • Orthopaedic Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1881707644
Registry record updated Feb 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ST LOUIS ORTHOPEDIC INSTITUTE INC
Practice address
12855 North Forty Drive
Suite 125
St Louis, MO 63141
Phone
(314) 543-2123
Fax
(314) 966-1023
NPI assigned
Aug 16, 2006
Last updated
Feb 7, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2012

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

Authorized official

Name
Keith J Odegard, MDNPI 1083609614
Title
Vice President
Phone
(314) 966-0111

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
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

12855 North Forty Drive
Suite 125
St Louis, MO 63141

Mailing address

12813 Flushing Meadows Drive
Suite 210
St. Louis, MO 63131
Phone (314) 543-2123

National Provider Directory

National Provider Directory

Locations

505 Couch Ave
Ste 25
Kirkwood, MO 63122
Phone (314) 543-2123

10777 Sunset Office Dr
Ste 120
Saint Louis, MO 63127
Phone (314) 251-6710

12813 Flushing Meadows Dr
Ste 210
Saint Louis, MO 63131

Practitioners & affiliated clinicians

Practitioners 10

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": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328572800000",
    "number": "1881707644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12813 FLUSHING MEADOWS DRIVE",
            "address_2": "SUITE 210",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63131",
            "telephone_number": "314-543-2123",
            "fax_number": "314-966-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12855 NORTH FORTY DRIVE",
            "address_2": "SUITE 125",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-543-2123",
            "fax_number": "314-966-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LOUIS ORTHOPEDIC INSTITUTE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2012-02-07",
        "status": "A",
        "authorized_official_last_name": "ODEGARD",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "314-966-0111",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 7, 2012; 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.