NPIMap

Organization Active NPI

Saint Louis University

  • Student in an Organized Health Care Education/Training Program
  • Saint Louis, MO
National Provider Identifier
1215468491
Registry record updated Mar 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Legal business name
SAINT LOUIS UNIVERSITY
Practice address
3660 Vista Ave
Saint Louis, MO 63110-2540
Phone
(314) 977-6100
NPI assigned
Mar 21, 2017
Organization subpart
Yes
Parent organization
SAINT LOUIS UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 21, 2017

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

Authorized official

Name
Fred Buckhold III, M.D.
Title
Program Director
Phone
(314) 577-8762

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193200000X MULTI-SPECIALTY GROUP 390200000X Primary

Addresses

Primary practice location

3660 Vista Ave
Saint Louis, MO 63110-2540

Mailing address

1402 S Grand Blvd
Saint Louis, MO 63104-1004
Phone (314) 577-8762

Other names 1

  • SLUCare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Slucare Dept of Neuro S16 organizations share this tax ID, including this one
Part of
Slucare Dept of Neuro S

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490054400000",
    "number": "1215468491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041004",
            "telephone_number": "314-577-8762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 VISTA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102540",
            "telephone_number": "314-977-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT LOUIS UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAINT LOUIS UNIVERSITY",
        "enumeration_date": "2017-03-21",
        "last_updated": "2017-03-21",
        "status": "A",
        "authorized_official_last_name": "BUCKHOLD",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "314-577-8762",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SLUCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 21, 2017; 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.