NPIMap

Organization Active NPI

Provident Place Consumer Directed Services

  • Health Maintenance Organization
  • Saint Louis, MO
National Provider Identifier
1053859397
Registry record updated Feb 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
PROVIDENT PLACE CONSUMER DIRECTED SERVICES
Practice address
1515 N Warson Rd
Suite 241
Saint Louis, MO 63132-1111
Phone
(314) 922-9841
NPI assigned
Feb 7, 2017
Last updated
Feb 7, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2017

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

Authorized official

Name
Aigner R SmithNPI 1518401298
Title
Owner
Phone
(314) 922-9841

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
Health Maintenance Organization 302R00000X NU Primary

Addresses

Primary practice location

1515 N Warson Rd
Suite 241
Saint Louis, MO 63132-1111

Mailing address

1515 N Warson Rd
Suite 241
Saint Louis, MO 63132-1111
Phone (314) 922-9841

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486425600000",
    "number": "1053859397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 N WARSON RD",
            "address_2": "SUITE 241",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631321111",
            "telephone_number": "314-922-9841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 N WARSON RD",
            "address_2": "SUITE 241",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631321111",
            "telephone_number": "314-922-9841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENT PLACE CONSUMER DIRECTED SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-07",
        "last_updated": "2017-02-07",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "AIGNER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-922-9841"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; 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.