Florissant Pediatrics Inc

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

R8596 Issued in MO

Legal business name

FLORISSANT PEDIATRICS INC

Practice address

4129 N US Highway 67
Florissant, MO 63034-2825

Phone

(314) 355-6390

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Elinor Hancock, M.D.

Title

President

Phone

(314) 355-6390

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331856000000",
    "number": "1245349281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1209",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630430209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4129 N US HIGHWAY 67",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630342825",
            "telephone_number": "314-355-6390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORISSANT PEDIATRICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-03-16",
        "status": "A",
        "authorized_official_last_name": "HANCOCK",
        "authorized_official_first_name": "ELINOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-355-6390",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "R8596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202179230",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Florissant, MO
• Providers in Florissant, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.