NPIMap

Organization Active NPI

Surgical Supply Solutions

  • Surgical Physician Assistant
  • O Fallon, MO
National Provider Identifier
1033783576
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Legal business name
SURGICAL SUPPLY SOLUTIONS
Practice address
2425 Sansonnet LN
O Fallon, MO 63368-3597
Phone
(501) 658-6186
NPI assigned
May 19, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael Edwin Farrell, CFANPI 1699148429
Title
Owner
Phone
(501) 658-6186

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X Primary

Addresses

Primary practice location

2425 Sansonnet LN
O Fallon, MO 63368-3597

Mailing address

2425 Sansonnet LN
O Fallon, MO 63368-3597
Phone (501) 658-6186

Other names 1

  • Surgical Supply Solutions Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675123200000",
    "number": "1033783576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 SANSONNET LN",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633683597",
            "telephone_number": "501-658-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 SANSONNET LN",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633683597",
            "telephone_number": "501-658-6186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL SUPPLY SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-19",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A",
        "authorized_official_last_name": "FARRELL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-658-6186",
        "authorized_official_credential": "CFA"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surgical Supply Solutions",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Surgical Supply Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in O Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.