NPIMap

Organization Active NPI

Urology of St. Louis, Inc.

  • Specialist
  • Saint Louis, MO
National Provider Identifier
1407716616
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
UROLOGY OF ST. LOUIS, INC.
Practice address
3009 N Ballas Rd Ste 250C
Saint Louis, MO 63131-2323
Phone
(314) 806-1770
Fax
(314) 558-9017
NPI assigned
Nov 12, 2025
Organization subpart
Yes
Parent organization
UROLOGY OF ST. LOUIS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Authorized official

Name
Angie Smith
Title
Credentialing Manager
Phone
(314) 336-5062

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

3009 N Ballas Rd Ste 250C
Saint Louis, MO 63131-2323

Mailing address

12855 N 40 Dr Ste 375
Saint Louis, MO 63141-8657
Phone (314) 567-6071

Other names 1

  • Neurosurgery of St Louis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260116003071 MO DME Supplier - Multi-Specialty - Physician 6204723786 Practice locations: Saint Louis, MO

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Urology of St Louis Inc6 organizations share this tax ID, including this one
Part of
Urology of St Louis Inc

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1762905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762905600000",
    "number": "1407716616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12855 N 40 DR STE 375",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418657",
            "telephone_number": "314-567-6071",
            "fax_number": "314-453-9965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD STE 250C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312323",
            "telephone_number": "314-806-1770",
            "fax_number": "314-558-9017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGY OF ST. LOUIS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UROLOGY OF ST. LOUIS, INC.",
        "enumeration_date": "2025-11-12",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "314-336-5062"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neurosurgery of St Louis",
            "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 Nov 12, 2025; 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.