Surgery Specialists of Missouri LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

SURGERY SPECIALISTS OF MISSOURI LLC

Practice address

10007 Kennerly Rd
Suite a
Saint Louis, MO 63128-2179

Phone

(314) 776-7112

Fax

(314) 776-7114

NPI assigned

May 22, 2008

Organization subpart

No

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

Authorized official

Name

Van L Wagner, MD

Title

Member

Phone

(314) 776-7112

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stacey E Brouk, RD, LD

  • Registered Dietitian
  • Saint Louis, MO
  • NPI 1558511048
  NPD (past)

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375056000000",
    "number": "1487811873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29255",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631260255",
            "telephone_number": "314-776-7112",
            "fax_number": "314-776-7114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10007 KENNERLY RD",
            "address_2": "SUITE A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282179",
            "telephone_number": "314-776-7112",
            "fax_number": "314-776-7114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY SPECIALISTS OF MISSOURI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2013-07-29",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "VAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "314-776-7112",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynn C Suresh, CPNP-AC
• Rama Suresh, MD
• Vanessa Vogel Suresh, MS, CCC-SLP
• Connor Surgeon
• Surgery Specialist of St. Louis
• Surgical Care Foundation
• Surgical Diagnostics & Therapy LLC
• Jagdish Suri, M.D.
• Jill Christine Surmeier, DPT
• Eleatha L Surratt, MD

• Specialist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Specialist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; 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.