Pediatrix Medical Group

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

2000169319 Issued in MO

Legal business name

PEDIATRIX MEDICAL GROUP

Practice address

621 S New Ballas Rd
Suite 2016B
Saint Louis, MO 63141-8232

Phone

(314) 251-5860

Fax

(314) 251-5861

NPI assigned

Jul 2, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jay A Brenner, MDNPI 1609832617

Title

Director

Phone

(314) 251-5860

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jay Allan Brenner, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Saint Louis, MO
  • NPI 1609832617
  Authorized official Same address or phone

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235168980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "SUITE 2016B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-5860",
            "fax_number": "314-251-5861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "SUITE 2016B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-5860",
            "fax_number": "314-251-5861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIX MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRENNER",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "314-251-5860",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MO",
            "license": "2000169319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Pederson
• Pediatric Behavior Specialists, LLC
• Pediatric Care for Kids
• Pediatric Orthotic and Prosthetic Services - Northwest, LLC
• Pediatric Urology Specialists, PC
• Pediatrix Medical Group
• Pediatrix Medical Group of Missouri, P.C.
• Pedirite Medical Mo LLC
• Leticia Pedroso Salaro Telles
• Peds' Needs Inc

• Neonatal-Perinatal Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Neonatal-Perinatal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.