St. Louis General Surgery, PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

R7B83 Issued in MO

Legal business name

ST. LOUIS GENERAL SURGERY, PC

Practice address

3394 McKelvey Rd
Suite 115
Bridgeton, MO 63044-2531

Phone

(314) 770-2223

Fax

(314) 770-2201

NPI assigned

Mar 15, 2007

Organization subpart

No

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

Authorized official

Name

David A Terschluse, MD

Title

President

Phone

(314) 770-2223

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456185600000",
    "number": "1407980931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3394 MCKELVEY RD",
            "address_2": "SUITE 115",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442531",
            "telephone_number": "314-770-2223",
            "fax_number": "314-770-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3394 MCKELVEY RD",
            "address_2": "SUITE 115",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442531",
            "telephone_number": "314-770-2223",
            "fax_number": "314-770-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LOUIS GENERAL SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2016-02-23",
        "status": "A",
        "authorized_official_last_name": "TERSCHLUSE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-770-2223",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MO",
            "license": "R7B83",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202110607",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CS4109",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Bridgeton, MO
• Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; 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.