NPIMap

Organization Active NPI

Neurological Diagnostics, LLC

  • Neurology Physician
  • Bridgeton, MO
National Provider Identifier
1174897862
Registry record updated Feb 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
30655 Issued in MO
Legal business name
NEUROLOGICAL DIAGNOSTICS, LLC
Practice address
12266 Depaul Dr
Suite 130
Bridgeton, MO 63044-2514
Phone
(314) 291-2446
Fax
(314) 291-7150
NPI assigned
Feb 28, 2012
Last updated
Feb 28, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2012

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

Authorized official

Name
Dr. Glenn M Sherrod, D.O.
Title
President
Phone
(314) 291-2446

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 30655 MO Primary

Addresses

Primary practice location

12266 Depaul Dr
Suite 130
Bridgeton, MO 63044-2514

Mailing address

12266 Depaul Drive
Suite 130
Bridgeton, MO 63044-2514
Phone (314) 291-2446

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1330387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330387200000",
    "number": "1174897862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12266 DEPAUL DRIVE",
            "address_2": "SUITE 130",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442514",
            "telephone_number": "314-291-2446",
            "fax_number": "314-291-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12266 DEPAUL DR",
            "address_2": "SUITE 130",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442514",
            "telephone_number": "314-291-2446",
            "fax_number": "314-291-7150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGICAL DIAGNOSTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-28",
        "last_updated": "2012-02-28",
        "status": "A",
        "authorized_official_last_name": "SHERROD",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-291-2446",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "30655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2012; 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.