Active NPI
Elite Surgical Assisting LLC
- Family Nurse Practitioner
- Saint Louis, MO
National Provider Identifier
1154793248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- ELITE SURGICAL ASSISTING LLC
- Practice address
- 2355 Dougherty Ferry Rd Ste 430
Saint Louis, MO 63122-3325 - Phone
- (888) 826-4546
- Fax
- (888) 826-4546
- NPI assigned
- Oct 28, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Darin M. Minkin, D.O.
- Title
- Administrator
- Phone
- (314) 965-8622
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse First Assistant | 163WR0006X | |||
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
2355 Dougherty Ferry Rd Ste 430
Saint Louis, MO 63122-3325
Mailing address
PO Box 323
New Melle, MO 63365-0323
Phone (888) 826-4546
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Surgery Physician
- Saint Louis, MO
- NPI 1043296494
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445990400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1544140800000",
"number": "1154793248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 323",
"city": "NEW MELLE",
"state": "MO",
"postal_code": "633650323",
"telephone_number": "888-826-4546",
"fax_number": "888-826-4546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2355 DOUGHERTY FERRY RD STE 430",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631223325",
"telephone_number": "888-826-4546",
"fax_number": "888-826-4546"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ELITE SURGICAL ASSISTING LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-10-28",
"last_updated": "2018-12-07",
"status": "A",
"authorized_official_last_name": "MINKIN",
"authorized_official_first_name": "DARIN",
"authorized_official_middle_name": "M.",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "314-965-8622",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.O."
},
"taxonomies": [
{
"code": "163WR0006X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse, Registered Nurse First Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Dec 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.