NPIMap

Organization Active NPI

Innovative Infusions, LLC

  • Infusion Therapy Clinic/Center
  • Saint Louis, MO
National Provider Identifier
1134821309
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X
Legal business name
INNOVATIVE INFUSIONS, LLC
Practice address
12669 Olive Blvd Ste a
Saint Louis, MO 63141-6333
Phone
(314) 710-5021
NPI assigned
Mar 20, 2023
Organization subpart
Yes
Parent organization
INNOVATIVE INFUSIONS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Authorized official

Name
Nicholas Maroulis, PHARMD
Title
Vice President
Phone
(689) 263-5021

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Clinic/Center 261QI0500X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

12669 Olive Blvd Ste a
Saint Louis, MO 63141-6333

Mailing address

3033 W President George Bush Hwy Ste 100B
Plano, TX 75075-5885
Phone (972) 588-1000

Other names 1

  • Paragon Infusion Centers Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address LicensingTeam@paragonhealthcare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221011001133 MO Part B Supplier - Clinic/Group Practice 6608054044 Receives reassigned benefits from 9 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Independence, MO; Kansas City, MO; Saint Louis, MO

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D2289954Paragon Infusion12669 Olive BLD Suite 9, Saint Louis, MO 63141Certificate of waiverSep 17, 2027

National Provider Directory

National Provider Directory
Tax ID family
Innovative Infusions LLC21 organizations share this tax ID, including this one
Part of
Innovative Infusions LLC

Other organizations with this tax ID 20

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

View all 20

Locations

4851 Cahaba River Rd
Ste 137
Vestavia, AL 35243
Phone (205) 963-7523

20120 E Jackson Dr
Ste C
Independence, MO 64057
Phone (816) 756-2791

11693 Westheimer Rd
Ste 180
Houston, TX 77077
Phone (346) 355-4352

21927 Clay Rd
Ste 900
Katy, TX 77449
Phone (832) 709-1064

6823 82nd St
Ste 100
Lubbock, TX 79424
Phone (806) 810-4651

2320 W Loop 340
Ste 100B
Waco, TX 76711
Phone (254) 730-4168

Practitioners & affiliated clinicians

Practitioners 7

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": "1679270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780617600000",
    "number": "1134821309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 W PRESIDENT GEORGE BUSH HWY STE 100B",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750755885",
            "telephone_number": "972-588-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12669 OLIVE BLVD STE A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416333",
            "telephone_number": "314-710-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE INFUSIONS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INNOVATIVE INFUSIONS, LLC",
        "enumeration_date": "2023-03-20",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A",
        "authorized_official_last_name": "MAROULIS",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "689-263-5021",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "LicensingTeam@paragonhealthcare.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12669 Olive Blvd Ste A",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631416333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Paragon Infusion Centers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Paragon Infusion Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.