Orthopedic & Sports Medicine Clinic, P.C.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

036074778 Issued in IL

Legal business name

ORTHOPEDIC & SPORTS MEDICINE CLINIC, P.C.

Practice address

4411 Alby St
Alton, IL 62002-5916

Phone

(618) 474-8052

Fax

(618) 474-8054

NPI assigned

Jul 8, 2006

Last updated

Mar 11, 2010By 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

Dr. Bruce T Vest, M.D.NPI 1710910583

Title

President

Phone

(618) 474-8052

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Riverside Ambulatory Surgery Center, LLC

  dba The Endoscopy & Colonoscopy Center

  • Ambulatory Surgical Clinic/Center
  • Hazelwood, MO
  • NPI 1366515504

  Member Of

  NPD member

Practitioners 16

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.

• Bruce T Vest, M.D.

  • Orthopaedic Surgery Physician
  • Alton, IL
  • NPI 1710910583
  Medicare reassignment Authorized official
• Larry Dean Hawkins, PT

  • Physical Therapist
  • East Alton, IL
  • NPI 1437115045
  Medicare reassignment NPD
• Kathryn Clark, PA-C

  • Physician Assistant
  • Saint Louis, MO
  • NPI 1912610163

  IL

  Medicare reassignment
• Gerald Henry Bemis, D.C.

  • Chiropractor
  • Alton, IL
  • NPI 1083770242
  NPD (past)
• Gerald Henry Bemis Jr., D.C.

  • Chiropractor
  • Alton, IL
  • NPI 1295891463
  NPD (past)
• Alice J Buzzard, LPTA

  • Physical Therapy Assistant
  • Alton, IL
  • NPI 1922441831
  NPD (past)
• Daniel M. Jones, D.C.

  • Orthopedic Chiropractor
  • Bunker Hill, IL
  • NPI 1366444853
  NPD (past)
• Richard A Jones, D.C.

  • Chiropractor
  • Bunker Hill, IL
  • NPI 1629070248
  NPD (past)
• John Edward Lindsay, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Alton, IL
  • NPI 1245444819
  NPD (past)
• Todd Edward Meiser, LPT

  • Physical Therapist
  • Bethalto, IL
  • NPI 1922061233
  NPD (past)
• David Motzer, ATC

  • Athletic Trainer
  • Alton, IL
  • NPI 1255781563
  NPD (past)
• Kyle Shepperson, MD

  • Orthopaedic Surgery Physician
  • Maryville, IL
  • NPI 1407831704
  NPD (past)

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268265600000",
    "number": "1982637658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 ALBY ST",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620025916",
            "telephone_number": "618-474-8052",
            "fax_number": "618-474-8054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 ALBY ST",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620025916",
            "telephone_number": "618-474-8052",
            "fax_number": "618-474-8054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC & SPORTS MEDICINE CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2010-03-11",
        "status": "A",
        "authorized_official_last_name": "VEST",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-474-8052",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036074778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036074778",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mohamedtarek A Omran, BDS
• Marissa Anne Ontis, FNP-C
• Kelsey Marie Orf, AGNP
• Samantha Orlandini, AS
• Orthopaedic Solutions, Inc
• Terry Jon Ortman, D.D.S.
• Osf Healthcare System (Osf Saint Anthony's Health Center-Snu)
• Osf Healthcare System (Osf Saint Anthony's Health Center)
• Osf Healthcare System (Osf Saint Anthony's Health Center-Home Health)
• Osf Healthcare System (OSF Saint Anthony's Health Center)

• Orthopaedic Surgery Physician in Alton, IL
• Providers in Alton, IL by specialty
• Orthopaedic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2010; 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.