NPIMap

Organization Active NPI

Vision Surgical Arts, LLC

Doing business as Oral Facial Surgery Institute

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Saint Louis, MO
National Provider Identifier
1366039075
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
Legal business name
VISION SURGICAL ARTS, LLC
Doing business as
Oral Facial Surgery Institute
Practice address
621 S New Ballas Rd Ste 16a
Saint Louis, MO 63141-8239
Phone
(314) 251-6725
NPI assigned
Dec 29, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Authorized official

Name
Lacy Wilson
Title
Business Manager
Phone
(314) 251-6725

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.)Group: 193400000X SINGLE SPECIALTY GROUP 204E00000X Primary

Addresses

Primary practice location

621 S New Ballas Rd Ste 16a
Saint Louis, MO 63141-8239

Mailing address

621 S New Ballas Rd Ste 16a
Saint Louis, MO 63141-8239
Phone (314) 251-6725

Other practice location 1

60 E North St
Eureka, MO 63025-1205
Phone (636) 938-6725

Other practice location 2

2997 Clarkson Rd Ste 120
Chesterfield, MO 63017-7321
Phone (636) 400-6725

Other practice location 3

2747 W Clay St Ste B
Saint Charles, MO 63301-2557
Phone (636) 594-6725

Other names 1

  • Oral Facial Surgery Institute Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210323000641 MO Part B Supplier - Clinic/Group Practice 5193132975 Receives reassigned benefits from 11 practitioners
Practice locations: Saint Louis, MO

National Provider Directory

National Provider Directory

Locations

2747 W Clay St
Ste B
Saint Charles, MO 63301
Phone (636) 594-6725

2747 W Clay St
Saint Charles, MO 63301
Phone (314) 862-0700

621 S New Ballas Rd
Ste 1
Saint Louis, MO 63141
Phone (314) 251-6725

Practitioners & affiliated clinicians

Practitioners 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1366039075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 16A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418239",
            "telephone_number": "314-251-6725",
            "fax_number": "314-251-6726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 16A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418239",
            "telephone_number": "314-251-6725"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 E North St",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "MO",
            "postal_code": "630251205",
            "country_code": "US",
            "telephone_number": "636-938-6725",
            "fax_number": "636-938-6721",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2997 Clarkson Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630177321",
            "country_code": "US",
            "telephone_number": "636-400-6725",
            "fax_number": "636-400-6726",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2747 W Clay St Ste B",
            "address_purpose": "LOCATION",
            "city": "Saint Charles",
            "state": "MO",
            "postal_code": "633012557",
            "country_code": "US",
            "telephone_number": "636-594-6725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VISION SURGICAL ARTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-29",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "LACY",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "314-251-6725"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oral Facial Surgery Institute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Oral Facial Surgery Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.