NPIMap

Organization Active NPI

Carestl Health

  • Dental Clinic/Center
  • Saint Louis, MO
National Provider Identifier
1124231477
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
522 Issued in MO
Legal business name
CARESTL HEALTH
Practice address
5541 Riverview Blvd
St Louis, MO 63120-2443
Phone
(314) 389-4566
Fax
(314) 385-7859
NPI assigned
May 7, 2007
Last updated
Feb 6, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2019

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

Authorized official

Name
Mrs. Angela Renee Clabon
Title
Ceo
Phone
(314) 367-5820

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 522 MO Primary

Addresses

Primary practice location

5541 Riverview Blvd
St Louis, MO 63120-2443

Mailing address

5471 Dr Martin Luther King Dr
St Louis, MO 63112-4265
Phone (314) 367-5820

Other identifiers 1

IdentifierTypeStateIssuer
507433308MedicaidMO

National Provider Directory

National Provider Directory
Tax ID family
St Louis Comp Health CT23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

5541 Riverview Blvd
Saint Louis, MO 63120
Phone (314) 389-4566

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549411200000",
    "number": "1124231477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5471 DR MARTIN LUTHER KING DR",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "631124265",
            "telephone_number": "314-367-5820",
            "fax_number": "314-367-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5541 RIVERVIEW BLVD",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "631202443",
            "telephone_number": "314-389-4566",
            "fax_number": "314-385-7859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARESTL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2019-02-06",
        "status": "A",
        "authorized_official_last_name": "CLABON",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "314-367-5820",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MO",
            "license": "522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "507433308",
            "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 Feb 6, 2019; 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.