Brent V Stromberg, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

R4B42 Issued in MO

Practice address

11709 Old Ballas Rd
Suite 201
Creve Coeur, MO 63141-7029

Phone

(314) 997-8828

Fax

(314) 432-5105

NPI assigned

Jul 31, 2006

Last updated

Jan 22, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mid-West Podiatry and Associates, LLC

  • Foot & Ankle Surgery Podiatrist
  • Creve Coeur, MO
  • NPI 1609906577
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232582400000",
    "number": "1467468520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419074",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631419074",
            "telephone_number": "314-997-8828",
            "fax_number": "314-432-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11709 OLD BALLAS RD",
            "address_2": "SUITE 201",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417029",
            "telephone_number": "314-997-8828",
            "fax_number": "314-432-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROMBERG",
        "first_name": "BRENT",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2009-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MO",
            "license": "R4B42",
            "primary": true
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "MO",
            "license": "R4B42",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203062401",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy Stock
• Dennis K Stovall, D.M.D.
• Kelsey Straatmann, MA
• Kimberly Sue Streff, MS, CCC-SLP,BCBA,LBA
• Shelley Stretch, LPC
• Mitchell R Stumpf, D.M.D.
• Suburban Foot Care
• Thomas Evan Suddeth
• Allyson Suiter
• Hailey Jo Sullivan

• Plastic Surgery Physician in Creve Coeur, MO
• Providers in Creve Coeur, MO by specialty
• Plastic Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.