Organization Active NPI

Sugar Creek Cancer Center L.L.C.

  • Specialist
  • High Ridge, MO
National Provider Identifier
1124117841
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
R5409 Issued in MO
Legal business name
SUGAR CREEK CANCER CENTER L.L.C.
Practice address
324 Emerson Rd
Suite a
High Ridge, MO 63049-2542
Phone
(636) 677-1800
Fax
(636) 677-8800
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Dr. Mary W Conti, M D
Title
Member
Phone
(636) 677-1800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X R5635 MO
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X R5409 MO Primary

Addresses

Primary practice location

324 Emerson Rd
Suite a
High Ridge, MO 63049-2542

Mailing address

324 Emerson Rd
Suite a
High Ridge, MO 63049-2542
Phone (636) 677-1800

National Provider Directory

National Provider Directory

Locations

324 Emerson Rd
Ste a
High Ridge, MO 63049
Phone (636) 677-1800

324 Emerson Rd
Ste a
High Ridge, MO 63049
Phone (636) 376-4857

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1124117841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 EMERSON RD",
            "address_2": "SUITE A",
            "city": "HIGH RIDGE",
            "state": "MO",
            "postal_code": "630492542",
            "telephone_number": "636-677-1800",
            "fax_number": "636-677-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 EMERSON RD",
            "address_2": "SUITE A",
            "city": "HIGH RIDGE",
            "state": "MO",
            "postal_code": "630492542",
            "telephone_number": "636-677-1800",
            "fax_number": "636-677-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUGAR CREEK CANCER CENTER L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "CONTI",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "636-677-1800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "MO",
            "license": "R5635",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "MO",
            "license": "R5409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Ridge, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.