St. Louis Pediatrics, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

103771 Issued in MO

Legal business name

ST. LOUIS PEDIATRICS, LLC

Practice address

8 Ramsgate Dr
Olivette, MO 63132-4116

Phone

(314) 283-9198

NPI assigned

Apr 12, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Justin Ogbevoen, M.D

Title

President

Phone

(314) 283-9198

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1302566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302566400000",
    "number": "1649560558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3533 DUNN RD",
            "address_2": "STE 210",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630336761",
            "telephone_number": "314-283-9198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 RAMSGATE DR",
            "city": "OLIVETTE",
            "state": "MO",
            "postal_code": "631324116",
            "telephone_number": "314-283-9198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LOUIS PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-12",
        "last_updated": "2011-04-12",
        "status": "A",
        "authorized_official_last_name": "OGBEVOEN",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-283-9198",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MO",
            "license": "103771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Shlosberg, LCSW
• Luniva Singh
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• Richard Slocomb
• Meghna Sridhar
• Margaret C Steck, PT
• Alexis Steele
• Joseph Caleb Stoecklein, DPT
• Jayree Stone, M.ED. PLPC
• Davielle Swinson-Spears

• Primary Care Clinic/Center in Olivette, MO
• Providers in Olivette, MO by specialty
• Primary Care Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2011; 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.