Individual provider Active NPI

Chotchai Srisuro, M.D.

  • Gynecologic Oncology Physician
  • Saint Louis, MO
National Provider Identifier
1699818658
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
33186 Issued in MO
Practice address
533 Couch Ave
Suite 287
Saint Louis, MO 63122-5561
Phone
(314) 821-9144
Fax
(314) 821-8019
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X 33186 MO Primary

Addresses

Primary practice location

533 Couch Ave
Suite 287
Saint Louis, MO 63122-5561

Mailing address

533 Couch Ave
Suite 287
Saint Louis, MO 63122-5561
Phone (314) 821-9144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699818658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 COUCH AVE",
            "address_2": "SUITE 287",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631225561",
            "telephone_number": "314-821-9144",
            "fax_number": "314-821-8019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 COUCH AVE",
            "address_2": "SUITE 287",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631225561",
            "telephone_number": "314-821-9144",
            "fax_number": "314-821-8019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRISURO",
        "first_name": "CHOTCHAI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "MO",
            "license": "33186",
            "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 Jul 8, 2007; 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.