The Youthful Body, Inc.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

THE YOUTHFUL BODY, INC.

Practice address

10287 Clayton Rd
Suite 200
Saint Louis, MO 63124-1172

Phone

(314) 692-2639

Fax

(314) 692-2649

NPI assigned

Oct 20, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Erick Falconer, M.D.

Title

President

Phone

(314) 692-2639

Specialties & licenses 1

Addresses

Tax ID family

The Youthful Body Inc2 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.

• The Youthful Body Medical Spa

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1447494133
  NPD tax ID

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255996800000",
    "number": "1346576709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10287 CLAYTON ROAD",
            "address_2": "SUITE 200",
            "city": "LADUE",
            "state": "MO",
            "postal_code": "631241172",
            "telephone_number": "314-692-2639",
            "fax_number": "314-692-2649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10287 CLAYTON RD",
            "address_2": "SUITE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631241172",
            "telephone_number": "314-692-2639",
            "fax_number": "314-692-2649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE YOUTHFUL BODY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-20",
        "last_updated": "2009-10-20",
        "status": "A",
        "authorized_official_last_name": "FALCONER",
        "authorized_official_first_name": "ERICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-692-2639",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The War Room
• The Wellness Partnership Group LLC
• The Whiteville Drugstore, LLC
• The Whole You Wellness and Counseling Center LLC
• The Youthful Body Medical Spa
• Tama Saint The, MD
• Clay Dalton Thebeau, ATC
• Clayton E. Thebeau, D.O.
• Kayla Noelle Theberge, LPC
• Heather Theby

• Medical Specialty Clinic/Center in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Medical Specialty Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; 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.