St. Louis Women's Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

140-2 Issued in MO

Legal business name

ST. LOUIS WOMEN'S SURGERY CENTER, LLC

Doing business as

St. Louis Multispecialty Surgery Center

Practice address

884 Woods Mill Rd
Suite 100
Ballwin, MO 63011-3657

Phone

(636) 779-0079

Fax

(636) 779-0080

NPI assigned

Nov 6, 2006

Organization subpart

No

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

Authorized official

Name

Jennifer Baldock

Title

Officer and Authorized Official

Phone

(615) 234-5900

Specialties & licenses 1

Addresses

Other names 1

• St. Louis Multispecialty Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Listed as

St Louis Womens Surgery Center LLCCCN 26C0001079

Medicare certification status

ActiveFrom the Provider of Services file

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614902400000",
    "number": "1154400471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "884 WOODS MILL RD STE 100",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113657",
            "telephone_number": "636-779-0079",
            "fax_number": "636-779-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "884 WOODS MILL RD",
            "address_2": "SUITE 100",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113657",
            "telephone_number": "636-779-0079",
            "fax_number": "636-779-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LOUIS WOMEN'S SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5900"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MO",
            "license": "140-2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Louis Multispecialty Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Louis Multispecialty Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Ballwin, MO
• Providers in Ballwin, 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 Mar 5, 2021; 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.