NPIMap

Organization Active NPI

St. Louis Renal Care LLC. Prince Hall

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Saint Louis, MO
National Provider Identifier
1679776124
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
ST. LOUIS RENAL CARE LLC. PRINCE HALL
Practice address
4411 N Newstead Ave
2ND Floor Dialysis
Saint Louis, MO 63115-2534
Phone
(314) 879-6278
Fax
(314) 381-1685
NPI assigned
Jun 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Miss Gerdi Winkler, RN CNN
Title
Area Manager
Phone
(314) 920-6007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

4411 N Newstead Ave
2ND Floor Dialysis
Saint Louis, MO 63115-2534

Mailing address

4411 N Newstead Ave
2ND Floor Dialysis
Saint Louis, MO 63115-2534
Phone (314) 879-6278

National Provider Directory

National Provider Directory
Tax ID family
Ability Network5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4411 N Newstead Ave
Fl 2
Saint Louis, MO 63115
Phone (314) 381-7696

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679776124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 N NEWSTEAD AVE",
            "address_2": "2ND FLOOR DIALYSIS",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631152534",
            "telephone_number": "314-879-6278",
            "fax_number": "314-381-1685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 N NEWSTEAD AVE",
            "address_2": "2ND FLOOR DIALYSIS",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631152534",
            "telephone_number": "314-879-6278",
            "fax_number": "314-381-1685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LOUIS RENAL CARE LLC. PRINCE HALL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WINKLER",
        "authorized_official_first_name": "GERDI",
        "authorized_official_title_or_position": "AREA MANAGER",
        "authorized_official_telephone_number": "314-920-6007",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "RN CNN"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "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 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.