Organization Active NPI

Pain Relief Center of St Louis LLC

  • Family Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1356986541
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PAIN RELIEF CENTER OF ST LOUIS LLC
Practice address
1115 Olivette Executive Pkwy
Saint Louis, MO 63132-3259
Phone
(314) 282-3990
NPI assigned
Nov 12, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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

Authorized official

Name
Chandrachur BanerjeeNPI 1972666238
Title
Owner
Phone
(314) 282-3990

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1115 Olivette Executive Pkwy
Saint Louis, MO 63132-3259

Mailing address

1115 Olivette Executive Pkwy
Saint Louis, MO 63132-3259

National Provider Directory

National Provider Directory

Locations

1115 Olivette Executive Pkwy
Ste 100
Saint Louis, MO 63132
Phone (314) 282-3990

1115 Olivette Executive Pkwy
Saint Louis, MO 63132
Phone (314) 282-3990

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1573516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573516800000",
    "number": "1356986541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 OLIVETTE EXECUTIVE PKWY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631323259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 OLIVETTE EXECUTIVE PKWY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631323259",
            "telephone_number": "314-282-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN RELIEF CENTER OF ST LOUIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-12",
        "last_updated": "2019-11-12",
        "status": "A",
        "authorized_official_last_name": "BANERJEE",
        "authorized_official_first_name": "CHANDRACHUR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-282-3990"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; 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.