Longevity Care LLC

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

Legal business name

LONGEVITY CARE LLC

Practice address

221 Clarkson Executive Park
Ellisville, MO 63011-2173

Phone

(314) 741-3800

Fax

(314) 741-3801

NPI assigned

Feb 3, 2023

Organization subpart

No

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

Authorized official

Name

Sikander M Bajwa

Title

Ceo

Phone

(314) 616-1276

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

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

{
    "created_epoch": "1675382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677715200000",
    "number": "1467158121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 CLARKSON EXECUTIVE PARK",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630112173",
            "telephone_number": "314-741-3800",
            "fax_number": "314-741-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 CLARKSON EXECUTIVE PARK",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630112173",
            "telephone_number": "314-741-3800",
            "fax_number": "314-741-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGEVITY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-03",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A",
        "authorized_official_last_name": "BAJWA",
        "authorized_official_first_name": "SIKANDER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "314-616-1276"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Leonard, DC
• Life Skills Foundation
• Bryan J Lind, PT
• Heather Little
• Glen Brian Lojka, O.D.
• Melissa Kay Lorber, O.D.
• Elizabeth Lucas, MD
• Linda Lui, PHARM.D.
• Spencer Augustus Lunnemann, PHARMD
• Kristen Renee Ma

• Public Health & General Preventive Medicine Physician in Ellisville, MO
• Providers in Ellisville, MO by specialty
• Public Health & General Preventive Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; 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.