CMS-1500 Box 24J / 33a • NPI
1962815340
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
207XS0114X (CMS 02)
Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon)
Box 32 Service Location & ZIP+4
2071 GOOSE LAKE RD, SAUGET, IL, 62206-2822
✓ 9-Digit EDI 837 ZIP+4 (62206-2822)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1962815340 (R&R 1 LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1962815340 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | R&R 1 LLC |
| Plain-English Specialty | Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon) NUCC Code: 207XS0114X (Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery) |
| Certifying / Licensing Body | American Board of Orthopaedic Surgery (ABOS) |
| Practice Location Address | 2071 GOOSE LAKE RD, SAUGET, IL, 62206-2822 |
| Practice Telephone / Fax | Tel: (618) 857-2634 |
| Administrative Mailing Address | 9272 CADDYSHACK CIR, SAINT LOUIS, MO, 63127-1932 |
| Enumeration & Last Sync | Enumerated: 2014-06-03 | CMS Record Updated: 2014-06-03 |
| Authorized Official | MATTHEW BRADLEY (owner) |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (207XS0114X)
What Does Taxonomy Code 207XS0114X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207XS0114X translates to:
"Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (R&R 1 LLC)
Typical CPT / Diagnostic Procedures:- Total Knee Arthroplasty (CPT 27447) & Total Hip Arthroplasty (CPT 27130)
- Arthroscopic Rotator Cuff & ACL Ligament Reconstruction
- Intra-Articular Corticosteroid & Hyaluronic Acid Joint Injections (CPT 20610)
- Fracture Reduction, Internal Fixation & Carpal Tunnel Release
- NSAIDs & Selective COX-2 Inhibitors (Meloxicam, Celecoxib, Naproxen)
- Intra-Articular Triamcinolone Acetonide & Methylprednisolone
- Postoperative Venous Thromboembolism (VTE) Prophylaxis (Apixaban, Rivaroxaban)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207XS0114X — Orthopaedic Surgery, Adult Reconstructive Orthopaedic SurgeryPlain English: Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon) | State: IL | License: 036127269 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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