St. Louis Centers for Pain Management, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

ST. LOUIS CENTERS FOR PAIN MANAGEMENT, LLC

Practice address

3555 Sunset Office Dr Ste C102
Saint Louis, MO 63127-1014

Phone

(314) 858-1858

Fax

(314) 261-5043

NPI assigned

Nov 9, 2011

Last updated

Feb 11, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mitchell Liberman, DCNPI 1669695540

Title

Owner

Phone

(314) 858-1858

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mitchell Liberman, DC

  • Chiropractor
  • Saint Louis, MO
  • NPI 1669695540
  Authorized official Same address or phone

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

{
    "created_epoch": "1320796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549843200000",
    "number": "1528345295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 SUNSET OFFICE DR STE C102",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271014",
            "telephone_number": "314-858-1858",
            "fax_number": "314-261-5043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 SUNSET OFFICE DR STE C102",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271014",
            "telephone_number": "314-858-1858",
            "fax_number": "314-261-5043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LOUIS CENTERS FOR PAIN MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-09",
        "last_updated": "2019-02-11",
        "status": "A",
        "authorized_official_last_name": "LIBERMAN",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-858-1858",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "112767",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MO",
            "license": "112767",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "26D2077922",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• St. Louis Centers for Pain Management, LLC
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• General Practice Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• General Practice Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; 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.