R&R 1 LLC

Primary specialty

Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X

License

036127269 Issued in IL

Legal business name

R&R 1 LLC

Practice address

2071 Goose Lake Rd
Sauget, IL 62206-2822

Phone

(618) 857-2634

NPI assigned

Jun 3, 2014

Last updated

Jun 3, 2014By 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

Matthew Bradley, MD

Title

Owner

Phone

(314) 718-7276

Specialties & licenses 1

Addresses

Tax ID family

RR 1 LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• R&R 1 LLC

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Saint Louis, MO
  • NPI 1043622566
  NPD tax ID

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401753600000",
    "number": "1962815340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9272 CADDYSHACK CIR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271932",
            "telephone_number": "314-718-7276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2071 GOOSE LAKE RD",
            "city": "SAUGET",
            "state": "IL",
            "postal_code": "622062822",
            "telephone_number": "618-857-2634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R&R 1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-03",
        "last_updated": "2014-06-03",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-718-7276",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "IL",
            "license": "036127269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Reconstructive Orthopaedic Surgery Physician in Sauget, IL
• Providers in Sauget, IL by specialty
• Adult Reconstructive Orthopaedic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; 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.