Organization Active NPI

Paul Rottler MD PC

  • Plastic Surgery Physician
  • St. Louis, MO
National Provider Identifier
1639304058
Registry record updated Jul 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
R9G51 Issued in MO
Legal business name
PAUL ROTTLER MD PC
Practice address
13625 Big Bend Road
St. Louis, MO 63122-5568
Phone
(131) 496-6888
Fax
(131) 496-6581
NPI assigned
May 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2009

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

Authorized official

Name
Dr. Paul Rottler, M.D.
Title
President
Phone
(131) 496-6880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X R9G51 MO Primary

Addresses

Primary practice location

13625 Big Bend Road
St. Louis, MO 63122-5568

Mailing address

13625 Big Bend Road
St. Louis, MO 63122-5568
Phone (131) 496-6888

Other identifiers 1

IdentifierTypeStateIssuer
000008690OtherMOMEDICARE ID NUMBER

National Provider Directory

National Provider Directory

Locations

13625 Big Bend Rd
Saint Louis, MO 63122
Phone (314) 270-3881

505 Couch Ave
Ste 120
Saint Louis, MO 63122
Phone (314) 966-8880

NPI Registry JSON

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

{
    "created_epoch": "1243555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247443200000",
    "number": "1639304058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13625 BIG BEND ROAD",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631225568",
            "telephone_number": "131-496-6888",
            "fax_number": "131-496-6581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13625 BIG BEND ROAD",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631225568",
            "telephone_number": "131-496-6888",
            "fax_number": "131-496-6581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL ROTTLER MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-29",
        "last_updated": "2009-07-13",
        "status": "A",
        "authorized_official_last_name": "ROTTLER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "131-496-6880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "MO",
            "license": "R9G51",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID NUMBER",
            "identifier": "000008690",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2009; 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.