Ear Nose Throat Medical Service

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

Legal business name

EAR NOSE THROAT MEDICAL SERVICE

Practice address

226 S Woods Mill Rd Ste 44W
Chesterfield, MO 63017-3442

Phone

(314) 447-4995

Fax

(314) 682-6093

NPI assigned

Nov 5, 2019

Last updated

Oct 3, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kathleen Burk

Title

Designated Official

Phone

(314) 541-6838

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

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.

• Paul E. Burk, D.O.

  • Facial Plastic Surgery Physician
  • Chesterfield, MO
  • NPI 1790786838
  Medicare reassignment NPD

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

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664755200000",
    "number": "1407490105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 CLARKSON CLAYTON CTR STE 301",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630112145",
            "telephone_number": "314-541-6838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 S WOODS MILL RD STE 44W",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173442",
            "telephone_number": "314-447-4995",
            "fax_number": "314-682-6093"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 Mexico Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Saint Peters",
            "state": "MO",
            "postal_code": "633761666",
            "country_code": "US",
            "telephone_number": "636-936-5002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EAR NOSE THROAT MEDICAL SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-05",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A",
        "authorized_official_last_name": "BURK",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "DESIGNATED OFFICIAL",
        "authorized_official_telephone_number": "314-541-6838"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penelope Karla Durban, LPC
• Rachel Durnin
• Amy Marie Durso, MSN, RN, FNP-C
• Stephanie Joy Dusek, NP
• Shae Dwyer, DC
• Earl R. Larson, D.D.S., P.C. (Wildhorse Dental)
• John Easterling, MAC
• Russell Hugh Eaves, PT
• Edgerley Dental LLC (Chesterfield Woodlake Dental and Prosthodontics)
• Paul Douglas Edgerley, D.D.S., MDS

• Otolaryngology/Facial Plastic Surgery Physician in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; 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.