Surgical Diagnostics & Therapy LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

R4131 Issued in MO

Legal business name

SURGICAL DIAGNOSTICS & THERAPY LLC

Practice address

675 Old Ballas Rd
Ste 100a
Saint Louis, MO 63141-7083

Phone

(314) 569-2626

Fax

(314) 569-1711

NPI assigned

Nov 7, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth J Bennett, MDNPI 1528257698

Title

President

Phone

(314) 569-2626

Specialties & licenses 1

Addresses

Other names 1

• Kenneth J Bennett MD Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth J Bennett, MD

  • Specialist
  • St Louis, MO
  • NPI 1528257698
  NPD (past) Authorized official

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193875200000",
    "number": "1225019318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 411220",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631411220",
            "telephone_number": "314-569-2626",
            "fax_number": "314-569-1711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 OLD BALLAS RD",
            "address_2": "STE 100A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417083",
            "telephone_number": "314-569-2626",
            "fax_number": "314-569-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL DIAGNOSTICS & THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-07",
        "last_updated": "2007-11-01",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-569-2626",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "MO",
            "license": "R4131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kenneth J Bennett MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Vanessa Vogel Suresh, MS, CCC-SLP
• Connor Surgeon
• Surgery Specialist of St. Louis
• Surgery Specialists of Missouri LLC
• Surgical Care Foundation
• Jagdish Suri, M.D.
• Jill Christine Surmeier, DPT
• Eleatha L Surratt, MD
• Sriyanshi Suryadevara, PA
• Susan D Purcell MD Dermatology LLC

• Surgery Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; 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.