NPI Code Detail JSON Logo

1386010684 NPI number — ST PETERS BONE & JOINT SURGERY INC.

NPI Number: 1386010684
Health Care Provider/Practitioner: ST PETERS BONE & JOINT SURGERY INC.

Information about “1386010684” NPI (ST PETERS BONE & JOINT SURGERY INC.) exists in 1386010684 in HTML format HTML  |  1386010684 in plain Text format TXT  |  1386010684 in PDF (Portable Document Format) PDF  |  1386010684 in an XML format XML  formats.

NPI Number : 1386010684 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1386010684",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ST PETERS BONE & JOINT SURGERY INC.",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 430",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAINT PETERS",
    "MailingAddressStateName": "MO",
    "MailingAddressPostalCode": "63376-0008",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "636-441-3444",
    "MailingAddressFaxNumber": "636-441-9832",
    "FirstLinePracticeLocationAddress": "4701 HIGHWAY K",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "O FALLON",
    "PracticeLocationAddressStateName": "MO",
    "PracticeLocationAddressPostalCode": "63368-8692",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "636-441-3444",
    "PracticeLocationAddressFaxNumber": "636-441-9832",
    "EnumerationDate": "08/20/2015",
    "LastUpdateDate": "03/16/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "KIDD",
    "AuthorizedOfficialFirstName": "JIM",
    "AuthorizedOfficialMiddleName": "P",
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "636-441-3444",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207XX0004X",
          "TaxonomyName": "Orthopaedic Foot and Ankle Surgery Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "332B00000X",
          "TaxonomyName": "Durable Medical Equipment & Medical Supplies",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "335E00000X",
          "TaxonomyName": "Prosthetic/Orthotic Supplier",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207XS0117X",
          "TaxonomyName": "Orthopaedic Surgery of the Spine Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207X00000X",
          "TaxonomyName": "Orthopaedic Surgery Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

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