NPIMap

Organization Active NPI

Broad Midwest Anesthesia, LLC

  • Anesthesiology Physician
  • Saint Louis, MO
National Provider Identifier
1376705848
Registry record updated Aug 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
LC0897403 Issued in MO
Legal business name
BROAD MIDWEST ANESTHESIA, LLC
Practice address
12345 W Bend Dr
Suite 200
Saint Louis, MO 63128-2182
Phone
(314) 843-8000
NPI assigned
Jun 26, 2008
Last updated
Aug 12, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2019

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

Authorized official

Name
Gilbert L. Drozdow
Title
Chief Clinical Officer
Phone
(954) 838-2371

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X LC0897403 MO Primary

Addresses

Primary practice location

12345 W Bend Dr
Suite 200
Saint Louis, MO 63128-2182

Mailing address

501 Glades Rd
Boca Raton, FL 33432-1419
Phone (954) 838-2371

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

12345 W Bend Dr
Ste 200
Saint Louis, MO 63128
Phone (314) 843-8000

Practitioners & affiliated clinicians

Practitioners 32

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.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565568000000",
    "number": "1376705848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 GLADES RD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334321419",
            "telephone_number": "954-838-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12345 W BEND DR",
            "address_2": "SUITE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282182",
            "telephone_number": "314-843-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROAD MIDWEST ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-26",
        "last_updated": "2019-08-12",
        "status": "A",
        "authorized_official_last_name": "DROZDOW",
        "authorized_official_first_name": "GILBERT",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "954-838-2371"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "LC0897403",
            "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 Aug 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.