St. Louis Cardiovascular Institute, LLC

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

Legal business name

ST. LOUIS CARDIOVASCULAR INSTITUTE, LLC

Practice address

1028 S Kirkwood Rd
Kirkwood, MO 63122-7222

Phone

(314) 394-2255

Fax

(618) 394-2253

NPI assigned

Aug 7, 2019

Organization subpart

No

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

Authorized official

Name

Mr. David Russell Horace

Title

Managing Member

Phone

(618) 235-2299

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565136000000",
    "number": "1548815491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 S KIRKWOOD RD",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631227222",
            "telephone_number": "314-394-2255",
            "fax_number": "618-394-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 S KIRKWOOD RD",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631227222",
            "telephone_number": "314-394-2255",
            "fax_number": "618-394-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LOUIS CARDIOVASCULAR INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-07",
        "last_updated": "2019-08-07",
        "status": "A",
        "authorized_official_last_name": "HORACE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "618-235-2299",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Interventional Cardiology Physician in Kirkwood, MO
• Providers in Kirkwood, MO by specialty
• Interventional Cardiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.