Children'S Gastroenterology of St. Louis, P.C.

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

Legal business name

CHILDREN'S GASTROENTEROLOGY OF ST. LOUIS, P.C.

Practice address

224 S Woods Mill Rd Ste 640
Chesterfield, MO 63017-3451

Phone

(314) 576-2080

Fax

(314) 576-0028

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jerry L Rosenblum, M.D.

Title

President

Phone

(314) 576-2080

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679699060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 S WOODS MILL RD STE 640",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173451",
            "telephone_number": "314-576-2080",
            "fax_number": "314-576-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 S WOODS MILL RD STE 640",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173451",
            "telephone_number": "314-576-2080",
            "fax_number": "314-576-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S GASTROENTEROLOGY OF ST. LOUIS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROSENBLUM",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-576-2080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Gastroenterology Physician in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Pediatric Gastroenterology Physician 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.