Creve Coeur Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

110-4 Issued in MO

Legal business name

CREVE COEUR SURGERY CENTER LLC

Practice address

845 N New Ballas CT
Suite 100
Creve Coeur, MO 63141-7148

Phone

(314) 872-7100

Fax

(314) 872-0929

NPI assigned

Sep 30, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Carolyn Hollowood, R.N.

Title

Administrator

Phone

(314) 872-7100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• City Place Surgery Center Doing business as

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154318517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 NORTH NEW BALLAS COURT",
            "address_2": "SUITE 100",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417148",
            "telephone_number": "314-872-7100",
            "fax_number": "314-872-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 N NEW BALLAS CT",
            "address_2": "SUITE 100",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417148",
            "telephone_number": "314-872-7100",
            "fax_number": "314-872-0929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREVE COEUR SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLLOWOOD",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "314-872-7100",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MO",
            "license": "110-4",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "112514",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "City Place Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashley L Crecelius, OTR/L
• Creve Coeur Family Medicine, LLC
• Creve Coeur Fire Protection Dist
• Creve Coeur Internal Medicine, LLC
• Creve Coeur Periodontics, Inc.
• Creve Coeur Surgery Center, LLC
• Gail Christine Crofton, R.D., L.D., CDE
• Crossroads Family Chiropractic, LLC
• Chandler Alexander Croutch
• Crown Hospice of St. Louis, Inc.

• Ambulatory Surgical Clinic/Center in Creve Coeur, MO
• Providers in Creve Coeur, MO by specialty
• Ambulatory Surgical Clinic/Center in Missouri

• 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.

Verify at the official NPI Registry.