St Louis Spine and Joint Pain Specialists LLC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

2016035827 Issued in 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

Last updated

Jan 15, 2020By 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

Adam Shomstein, DONPI 1962793760

Title

Chief Officer

Phone

(314) 516-3289

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 2

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.

• Adam Shomstein, D.O.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Fenton, MO
  • NPI 1962793760
  Medicare reassignment Care Compare group NPD Authorized official
• Diana Mekler, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Ballwin, MO
  • NPI 1477843985
  Medicare reassignment Care Compare group NPD

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

{
    "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": []
}

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• St. Louis Dry Needling and Physical Therapy
• Tyler Alan Stahlman, DC

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Fenton, MO
• Providers in Fenton, MO by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.