SSM Cardinal Glennon Children's Hospital

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SSM CARDINAL GLENNON CHILDREN'S HOSPITAL

Doing business as

Cardinal Glennon Pediatric Surgery Center at Medical Park

Practice address

1475 Kisker Rd
Suite 120
Saint Charles, MO 63304-8781

Phone

(636) 498-7878

Fax

(636) 498-7420

NPI assigned

Apr 1, 2008

Last updated

Dec 22, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Sharon Dudley

Title

Evp/Coo

Phone

(314) 768-8032

Specialties & licenses 1

Addresses

Other names 1

• Cardinal Glennon Pediatric Surgery Center at Medical Park Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• SSM Cardinal Glennon Children's Hospital

  dba SSM Health Cardinal Glennon Pediatrics

  • Pediatrics Physician
  • Warrenton, MO
  • NPI 1962573212

  Member Of

  NPD member

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229904000000",
    "number": "1669644456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-577-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 KISKER RD",
            "address_2": "SUITE 120",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633048781",
            "telephone_number": "636-498-7878",
            "fax_number": "636-498-7420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSM CARDINAL GLENNON CHILDREN'S HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-12-22",
        "status": "A",
        "authorized_official_last_name": "DUDLEY",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "EVP/COO",
        "authorized_official_telephone_number": "314-768-8032",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cardinal Glennon Pediatric Surgery Center at Medical Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Speece, RNFA
• Samantha Jo Spiegel, DPT
• Robert John Spraul, MS OTR L
• Paige Spry, NP
• SRZ Op Frontier LLC (Frontier Health & Rehabilitation)
• SSM Cardiovascular and Thoracic Services, Inc.
• SSM Depaul Medical Group
• SSM Depaul Medical Group, Inc. (DePaul Medical Group at St. Charles)
• SSM Health Care Corporation
• SSM Health Care St Louis (SSM Health Home Infusion St Louis)

• Ambulatory Surgical Clinic/Center in Saint Charles, MO
• Providers in Saint Charles, 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 Dec 22, 2008; 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.