The Doretha Buie Center, LLC

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

THE DORETHA BUIE CENTER, LLC

Practice address

12330 Natural Bridge Rd
Bridgeton, MO 63044-2019

Phone

(314) 422-3489

NPI assigned

Jan 18, 2021

Organization subpart

No

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

Authorized official

Name

Stacey Baker

Title

Owner/Operator

Phone

(314) 422-3489

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1610928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610928000000",
    "number": "1295325827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2123 KEEVEN LN",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630316501",
            "telephone_number": "314-422-3489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12330 NATURAL BRIDGE RD",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442019",
            "telephone_number": "314-422-3489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DORETHA BUIE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-18",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "314-422-3489"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clarice Tennessen-Jensen, PHARMD
• Durwood Alan Tenny, OTR/L
• Sally Terranova, LMSW
• Terry Egan DDS LLC
• The Ambulatory Surgical Center of St. Louis, LP (The Surgical Center of St. Louis)
• David A Theodoro, M.D.
• Kristi Lynn Theriot, LPC
• Thomas Gotsis DDS PC
• Jamika Thomas
• Jazell Dailey Thomas, LPC,NCC

• Adult Day Care Clinic/Center in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Adult Day Care Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; 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.