Active NPI
Clinical Support Services, LLC
- Nurse Practitioner
- Saint Louis, MO
National Provider Identifier
1659503217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 209001766
- Legal business name
- CLINICAL SUPPORT SERVICES, LLC
- Practice address
- 1501 Locust St Apt 906
Saint Louis, MO 63103-1847 - Phone
- (618) 558-3955
- NPI assigned
- Aug 17, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ellen M Miller, NP
- Title
- Nurse Practitioner
- Phone
- (618) 558-3955
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209001766 | IL | Primary |
Addresses
Primary practice location
1501 Locust St Apt 906
Saint Louis, MO 63103-1847
Mailing address
1501 Locust St Apt 906
Saint Louis, MO 63103-1847
Phone (618) 558-3955
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250467200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1259539200000",
"number": "1659503217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 LOCUST ST APT 906",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631031847",
"telephone_number": "618-558-3955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 LOCUST ST APT 906",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631031847",
"telephone_number": "618-558-3955"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLINICAL SUPPORT SERVICES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2009-08-17",
"last_updated": "2009-11-30",
"status": "A",
"authorized_official_last_name": "MILLER",
"authorized_official_first_name": "ELLEN",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "NURSE PRACTITIONER",
"authorized_official_telephone_number": "618-558-3955",
"authorized_official_credential": "NP"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209001766",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.