Healthmark Ballas LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

HEALTHMARK BALLAS LLC

Practice address

456 N New Ballas Rd Ste 266
Saint Louis, MO 63141-6842

Phone

(314) 373-7000

Fax

(314) 373-7003

NPI assigned

Jan 9, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Mary Sue Ekstrom

Title

Office Manager

Phone

(314) 446-0050

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619026952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11600 MANCHESTER RD STE 101",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631314691",
            "telephone_number": "314-446-0050",
            "fax_number": "314-822-8476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 N NEW BALLAS RD STE 266",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416842",
            "telephone_number": "314-373-7000",
            "fax_number": "314-373-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHMARK BALLAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EKSTROM",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "314-446-0050",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Saint Louis, MO
• Providers in Saint Louis, 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 Aug 22, 2020; 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.