St Louis Spine and Joint Pain Specialists LLC

Key facts

NPI

1043762974

Entity type

Organization (NPI type 2)

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X

License

2016035827 (MO)

Legal business name

ST LOUIS SPINE AND JOINT PAIN SPECIALISTS LLC

Practice address

520 Center Street
Fenton, MO 63026-4246

Phone

(314) 516-3289

NPI assigned

Oct 26, 2016

Organization subpart

No

Authorized official

Name

Adam Shomstein, DO NPI 1962793760

Title

Chief Officer

Phone

(314) 516-3289

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

Practitioners 2

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

• Adam Shomstein, D.O. Pain Medicine (Physical Medicine & Rehabilitation) Physician · Fenton, MO · NPI 1962793760
  Medicare reassignment Care Compare group NPD Authorized official MO · PAIN MEDICINE
• Diana Mekler, M.D. Pain Medicine (Physical Medicine & Rehabilitation) Physician · Ballwin, MO · NPI 1477843985
  Medicare reassignment Care Compare group NPD MO · PAIN MEDICINE

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MO

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 15, 2020.

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579046400000",
    "number": "1043762974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 CENTER STREET",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "63026",
            "telephone_number": "314-516-3289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 CENTER STREET",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630264246",
            "telephone_number": "314-516-3289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1365 Nykiel Ct",
            "address_purpose": "LOCATION",
            "city": "Ballwin",
            "state": "MO",
            "postal_code": "630114246",
            "country_code": "US",
            "telephone_number": "704-222-2010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST LOUIS SPINE AND JOINT PAIN SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-26",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A",
        "authorized_official_last_name": "SHOMSTEIN",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "CHIEF OFFICER",
        "authorized_official_telephone_number": "314-516-3289",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "MO",
            "license": "2016035827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

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• St Anthony'S Physician Organization Private Practices LC
• St Louis Counseling Inc
• St Louis Dermatology LLC
• St. Anthony'S Physician Organization
• St. Anthony'S Physician Organization
• St. Anthony'S Physician Organization
• St. Louis Dry Needling and Physical Therapy
• Tyler Alan Stahlman, DC

All providers in Fenton, MO · Pain Medicine (Physical Medicine & Rehabilitation) Physician in Missouri