Organization Active NPI

Corporate Surgical Arts LLC

  • Phlebology Physician
  • O Fallon, MO
National Provider Identifier
1578280251
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebology PhysicianTaxonomy code 202K00000X
Legal business name
CORPORATE SURGICAL ARTS LLC
Practice address
1630 Market Center Blvd Ste 203
O Fallon, MO 63368-8407
Phone
(636) 397-4012
NPI assigned
Oct 24, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Authorized official

Name
Ms. Dawn Marie Simon
Title
Director of Business Operations
Phone
(636) 397-4012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 202K00000X Primary

Addresses

Primary practice location

1630 Market Center Blvd Ste 203
O Fallon, MO 63368-8407

Mailing address

1630 Market Center Blvd Ste 203
O Fallon, MO 63368-8407
Phone (636) 397-4012

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666569600000",
    "number": "1578280251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 MARKET CENTER BLVD STE 203",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633688407",
            "telephone_number": "636-397-4012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 MARKET CENTER BLVD STE 203",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633688407",
            "telephone_number": "636-397-4012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORPORATE SURGICAL ARTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-24",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS OPERATIONS",
        "authorized_official_telephone_number": "636-397-4012",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Phlebology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.