Active NPI
Ear Nose & Throat & Plastic Surg Inc
- Facial Plastic Surgery Physician
- Saint Louis, MO
National Provider Identifier
1104911288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Facial Plastic Surgery Physician
- Legal business name
- EAR NOSE & THROAT & PLASTIC SURG INC
- Practice address
- 2325 Dougherty Ferry Rd Ste 106
Saint Louis, MO 63122-3356 - Phone
- (314) 821-5002
- Fax
- (314) 821-5029
- NPI assigned
- Oct 4, 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
- Richard L Barnes, DO
- Title
- President
- Phone
- (314) 821-5002
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Facial Plastic Surgery Physician | 207YS0123X | MO | Primary |
Addresses
Primary practice location
2325 Dougherty Ferry Rd Ste 106
Saint Louis, MO 63122-3356
Mailing address
2325 Dougherty Ferry Rd Ste 106
Saint Louis, MO 63122-3356
Phone (314) 821-5002
Other practice location 1
12277 DePaul Dr Ste 303
Bridgeton, MO 63044-2529
Phone (314) 821-5002
Other practice location 2
4800 Mexico Rd Ste 103
Saint Peters, MO 63376-1666
Phone (314) 821-5002
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 040010750 | Other | MO | MEDICARE RAILROAD |
| CP2222 | Other | MO | MEDICARE RAILROAD |
| 040017959 | Other | MO | MEDICARE RAILROAD |
| 040003579 | Other | MO | MEDICARE RAILROAD |
| 502754401 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031206000062 | MO | Part B Supplier - Clinic/Group Practice | 0547165094 |
Receives reassigned benefits from 3 practitioners Practice locations: Bridgeton, MO; Saint Louis, MO; St Peters, MO |
National Provider Directory
National Provider DirectoryLocations
2325 Dougherty Ferry Rd
Ste 106
Saint Louis, MO 63122
Phone (314) 821-5002
Practitioners & affiliated clinicians
Practitioners 9
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Facial Plastic Surgery Physician
- Saint Louis, MO
- NPI 1386645463
Facial Plastic Surgery, MO
-
- Facial Plastic Surgery Physician
- Saint Louis, MO
- NPI 1629450937
Facial Plastic Surgery, MO
-
- Audiologist
- Creve Coeur, MO
- NPI 1114199957
-
- Audiologist
- Kirkwood, MO
- NPI 1760576326
-
- Audiologist
- Saint Louis, MO
- NPI 1962708727
-
- Specialist
- Saint Louis, MO
- NPI 1538202551
-
- Audiologist
- Fairfax, VA
- NPI 1174686281
-
- Audiologist
- Decatur, IL
- NPI 1912051863
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1759968000000",
"number": "1104911288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2325 DOUGHERTY FERRY RD STE 106",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631223356",
"telephone_number": "314-821-5002",
"fax_number": "314-821-5029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2325 DOUGHERTY FERRY RD STE 106",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631223356",
"telephone_number": "314-821-5002",
"fax_number": "314-821-5029"
}
],
"practiceLocations": [
{
"address_1": "12277 DePaul Dr Ste 303",
"address_purpose": "LOCATION",
"city": "Bridgeton",
"state": "MO",
"postal_code": "630442529",
"country_code": "US",
"telephone_number": "314-821-5002",
"fax_number": "314-821-8029",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4800 Mexico Rd Ste 103",
"address_purpose": "LOCATION",
"city": "Saint Peters",
"state": "MO",
"postal_code": "633761666",
"country_code": "US",
"telephone_number": "314-821-5002",
"fax_number": "314-821-5029",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "EAR NOSE & THROAT & PLASTIC SURG INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-04",
"last_updated": "2025-10-09",
"certification_date": "2025-10-09",
"status": "A",
"authorized_official_last_name": "BARNES",
"authorized_official_first_name": "RICHARD",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "314-821-5002",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "207YS0123X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Otolaryngology, Facial Plastic Surgery",
"state": "MO",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "040010750",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "CP2222",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "040017959",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "040003579",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "502754401",
"state": "MO"
}
],
"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 Oct 9, 2025; 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.