St. Louis Center for Preventive and Longevity Medicine, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

102881 Issued in MO

Legal business name

ST. LOUIS CENTER FOR PREVENTIVE AND LONGEVITY MEDICINE, LLC

Practice address

777 S New Ballas Rd
Suite 200 E
Saint Louis, MO 63141-8705

Phone

(314) 994-1536

Fax

(314) 692-0241

NPI assigned

May 24, 2007

Last updated

Dec 27, 2007By 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. Richard Allan Bligh, M.D.NPI 1306813050

Title

Medical Director

Phone

(314) 994-1536

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Richard Allan Bligh, MD

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1306813050
  Authorized official Same address or phone

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198713600000",
    "number": "1003027988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 S NEW BALLAS RD",
            "address_2": "SUITE 200 E",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418705",
            "telephone_number": "314-994-1536",
            "fax_number": "314-692-0241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 S NEW BALLAS RD",
            "address_2": "SUITE 200 E",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418705",
            "telephone_number": "314-994-1536",
            "fax_number": "314-692-0241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LOUIS CENTER FOR PREVENTIVE AND LONGEVITY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2007-12-27",
        "status": "A",
        "authorized_official_last_name": "BLIGH",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ALLAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "314-994-1536",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "102881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1306813050",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St. Louis Bone and Joint Center, LLC
• St. Louis Cancer Care, L.L.P.
• St. Louis Center for Family Development, LLC
• St. Louis Center for Family Development, LLC
• St. Louis Center for Preventative and Longevity Medicine
• St. Louis Center of Preventitive & Longevity Medicine, LLC
• St. Louis Centers for Pain Management, LLC
• St. Louis Centers for Pain Management, LLC
• St. Louis Charter School
• St. Louis Charter School

• Internal Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2007; 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.