Susan E. Pearson, LLC

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

DO101125 Issued in MO

Legal business name

SUSAN E. PEARSON, LLC

Practice address

6209 Midrivers Mall Dr
#317
St Charles, MO 63304-1102

Phone

(636) 244-4500

Fax

(636) 244-4505

NPI assigned

Jul 16, 2007

Organization subpart

No

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

Authorized official

Name

Susan E Pearson, DO

Title

Owner

Phone

(636) 244-4500

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184544000000",
    "number": "1487853750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6209 MIDRIVERS MALL DR",
            "address_2": "#317",
            "city": "ST CHARLES",
            "state": "MO",
            "postal_code": "633041102",
            "telephone_number": "636-244-4500",
            "fax_number": "636-244-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6209 MIDRIVERS MALL DR",
            "address_2": "#317",
            "city": "ST CHARLES",
            "state": "MO",
            "postal_code": "633041102",
            "telephone_number": "636-244-4500",
            "fax_number": "636-244-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN E. PEARSON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-16",
        "last_updated": "2007-07-16",
        "status": "A",
        "authorized_official_last_name": "PEARSON",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-244-4500",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MO",
            "license": "DO101125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Medicine (Family Medicine) Physician in St Charles, MO
• Providers in St Charles, MO by specialty
• Geriatric Medicine (Family Medicine) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.