Laser Spine Surgery Center of St. Louis, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

LASER SPINE SURGERY CENTER OF ST. LOUIS, LLC

Practice address

450 N New Ballas Rd
Creve Coeur, MO 63141-6835

Phone

(314) 930-2693

Fax

(484) 253-1790

NPI assigned

May 21, 2014

Organization subpart

Yes

Parent organization

LSI HOLDCO, LLCAs reported in NPPES

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

Authorized official

Name

Dr. Michael W Perry, MD

Title

Medical Director

Phone

(813) 289-9613

Specialties & licenses 1

Addresses

Other names 1

• Laser Spine Surgery Center of Missouri, LLC Former legal business name

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

{
    "created_epoch": "1400630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484179200000",
    "number": "1568874832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5332 AVION PARK DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336071412",
            "telephone_number": "813-682-2944",
            "fax_number": "484-253-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N NEW BALLAS RD",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416835",
            "telephone_number": "314-930-2693",
            "fax_number": "484-253-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LASER SPINE SURGERY CENTER OF ST. LOUIS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LSI HOLDCO, LLC",
        "enumeration_date": "2014-05-21",
        "last_updated": "2017-01-12",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "813-289-9613",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laser Spine Surgery Center of Missouri, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Lauren Landfried, RD, LD
• Nicole Lanius
• Lisa Ann Larose, M.ED, BCBA, LBA
• Derek Sloan Larson, M.D.
• Laser Spine Institute LL Sole MBR
• Lasik-1 of St. Louis, LLC
• Jessica J. Lavalle, DMD
• Grace Lynne Christine Lay, M.A., CF-SLP
• Kathleen Ann Leach-Ross, LPC
• Sung Kwang Lee, D.C.

• Ambulatory Surgical Clinic/Center in Creve Coeur, MO
• Providers in Creve Coeur, MO by specialty
• Ambulatory Surgical Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; 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.