Organization Active NPI

Surgery Centers of Missouri

  • Ambulatory Surgical Clinic/Center
  • Creve Coeur, MO
National Provider Identifier
1275286643
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SURGERY CENTERS OF MISSOURI
Practice address
12101 Woodcrest Executive Dr Ste 101
Creve Coeur, MO 63141-5047
Phone
(314) 378-2085
Fax
(314) 659-8307
NPI assigned
Jan 27, 2022
Last updated
Feb 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Authorized official

Name
William Douglas Kula CraggNPI 1548249626
Title
Owner/Ceo
Phone
(314) 695-8933

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary
Pain Medicine Physician 208VP0000X

Addresses

Primary practice location

12101 Woodcrest Executive Dr Ste 101
Creve Coeur, MO 63141-5047

Mailing address

1015 S. Spoede Rd.
Frontenac, MO 63131-2610
Phone (314) 695-8933

National Provider Directory

National Provider Directory
Tax ID family
Surgery Centers of Missouri2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

12101 Woodcrest Executive Dr
Ste 101
Saint Louis, MO 63141
Phone (314) 576-4500

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1643241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675814400000",
    "number": "1275286643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 S. SPOEDE RD.",
            "city": "FRONTENAC",
            "state": "MO",
            "postal_code": "631312610",
            "telephone_number": "314-695-8933",
            "fax_number": "314-659-8307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12101 WOODCREST EXECUTIVE DR STE 101",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631415047",
            "telephone_number": "314-378-2085",
            "fax_number": "314-659-8307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY CENTERS OF MISSOURI",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-27",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A",
        "authorized_official_last_name": "CRAGG",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "DOUGLAS KULA",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "314-695-8933"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Creve Coeur, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; 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.