Organization Active NPI

St Louis Cosmetic Surgery

  • Plastic and Reconstructive Surgery Physician
  • Chesterfield, MO
National Provider Identifier
1205023405
Registry record updated Oct 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
13172549 Issued in MO
Legal business name
ST LOUIS COSMETIC SURGERY
Practice address
17300 N Outer 40 Rd
Suite 300
Chesterfield, MO 63005
Phone
(636) 530-6161
Fax
(636) 777-7500
NPI assigned
Oct 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2007

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

Authorized official

Name
Mrs. Beth Burton
Title
Practice Manager
Phone
(636) 530-6161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0122X 13172549 MO Primary

Addresses

Primary practice location

17300 N Outer 40 Rd
Suite 300
Chesterfield, MO 63005

Mailing address

17300 N Outer 40 Rd
Suite 300
Chesterfield, MO 63005
Phone (636) 530-6161

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
26D2311896St Louis Cosmetic Surgery LLC17300 N Outer Forty Road, Suite 300, Chesterfield, MO 63005Certificate of waiverSep 30, 2026

National Provider Directory

National Provider Directory

Locations

17300 North Outer 40 Rd
Ste 300
Chesterfield, MO 63005
Phone (636) 530-6161

Practitioners & affiliated clinicians

Practitioners 5

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": "1191283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191283200000",
    "number": "1205023405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17300 N OUTER 40 RD",
            "address_2": "SUITE 300",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "63005",
            "telephone_number": "636-530-6161",
            "fax_number": "636-777-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17300 N OUTER 40 RD",
            "address_2": "SUITE 300",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "63005",
            "telephone_number": "636-530-6161",
            "fax_number": "636-777-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LOUIS COSMETIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-02",
        "last_updated": "2007-10-02",
        "status": "A",
        "authorized_official_last_name": "BURTON",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "636-530-6161",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MO",
            "license": "13172549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.