Active NPI
St Ann OB GYN Inc
- Obstetrics & Gynecology Physician
- St Louis, MO
National Provider Identifier
1063458305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- Legal business name
- ST ANN OB GYN INC
- Practice address
- 3009 N Ballas Road
Suite 356C
St Louis, MO 63131-2322 - Phone
- (314) 432-2880
- Fax
- (314) 432-4810
- NPI assigned
- Jun 22, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Fred R Monterubio Jr., MD
- Title
- VP Vice President
- Phone
- (314) 432-2880
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | Primary |
Addresses
Primary practice location
3009 N Ballas Road
Suite 356C
St Louis, MO 63131-2322
Mailing address
3009 N Ballas Road
Suite 356C
St Louis, MO 63131-2322
Phone (314) 432-2880
Other identifiers 15
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4217036 | Other | AETNA | |
| 101340 | Other | HEALTHLINK | |
| 5143 | Other | HEALTHCARE USA | |
| 0700216 | Other | MEDICARE COMPLETE | |
| 3951 | Other | HEALTHCARE USA | |
| 46319 | Other | GROUP HEALTH PLAN | |
| 4270227 | Other | AETNA | |
| 0700217 | Other | MEDICARE COMPLETE | |
| 112754 | Other | BLUE CROSS BLUE SHIELD | |
| 112759 | Other | BLUE CROSS BLUE SHIELD | |
| SP15671 | Other | CIGNA | |
| SP15678 | Other | CIGNA | |
| 0700217 | Other | UNITED HEALTHCARE | |
| 100174 | Other | HEALTHLINK | |
| 45077 | Other | GROUP HEALTH PLAN |
National Provider Directory
National Provider DirectoryLocations
2821 N Ballas Rd
Ste 255
Saint Louis, MO 63131
Phone (314) 432-2880
3009 N Ballas Rd
Ste 356C
Saint Louis, MO 63131
Phone (314) 432-2880
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1063458305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3009 N BALLAS ROAD",
"address_2": "SUITE 356C",
"city": "ST LOUIS",
"state": "MO",
"postal_code": "631312322",
"telephone_number": "314-432-2880",
"fax_number": "314-432-4810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3009 N BALLAS ROAD",
"address_2": "SUITE 356C",
"city": "ST LOUIS",
"state": "MO",
"postal_code": "631312322",
"telephone_number": "314-432-2880",
"fax_number": "314-432-4810"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST ANN OB GYN INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-22",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "MONTERUBIO",
"authorized_official_first_name": "FRED",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "VP VICE PRESIDENT",
"authorized_official_telephone_number": "314-432-2880",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4217036",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "101340",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHCARE USA",
"identifier": "5143",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE COMPLETE",
"identifier": "0700216",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHCARE USA",
"identifier": "3951",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP HEALTH PLAN",
"identifier": "46319",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4270227",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE COMPLETE",
"identifier": "0700217",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "112754",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "112759",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "SP15671",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "SP15678",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "0700217",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "100174",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP HEALTH PLAN",
"identifier": "45077",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in St Louis, MO
- SSM-Sluh Inc
- SSM-Sluh Inc
- SSM-Sluh, Inc.
- St Alexius Emergency Physicians LLC
- St Andrews at Home Services, LLC
- St Anthony'S Neurosurgery Services, LLC
- St Anthony'S Physician Organization Private Practices
- St Anthony'S Physician Organization Private Practices LC
- St Anthony'S Physician Organization Private Practices LC
- St Anthony'S Physician Organization Private Practices LC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.