NPIMap

Organization Active NPI

Healthmark St Peters

  • Ambulatory Surgical Clinic/Center
  • Des Peres, MO
National Provider Identifier
1457540858
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
HEALTHMARK ST PETERS
Practice address
11600 Manchester Rd
Ste 101 Healthmark St Peters LLC
Des Peres, MO 63131
Phone
(314) 446-0050
NPI assigned
Oct 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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

Authorized official

Name
Sue Ekstrom
Title
Office Manager
Phone
(314) 446-0050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

11600 Manchester Rd
Ste 101 Healthmark St Peters LLC
Des Peres, MO 63131

Mailing address

225 First Executive Ave
St Peters, MO 63376
Phone (314) 446-0050

National Provider Directory

National Provider Directory

Locations

225 First Executive Ave
St Peters, MO 63376

NPI Registry JSON

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193011200000",
    "number": "1457540858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 FIRST EXECUTIVE AVE",
            "city": "ST PETERS",
            "state": "MO",
            "postal_code": "63376",
            "telephone_number": "314-446-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 MANCHESTER RD",
            "address_2": "STE 101 HEALTHMARK ST PETERS LLC",
            "city": "DES PERES",
            "state": "MO",
            "postal_code": "63131",
            "telephone_number": "314-446-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHMARK ST PETERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2007-10-22",
        "status": "A",
        "authorized_official_last_name": "EKSTROM",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "314-446-0050"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Peres, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; 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.