Mid-County Urology Inc

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

R4A96 Issued in MO

Legal business name

MID-COUNTY UROLOGY INC

Practice address

621 S New Ballas Rd
Suite 6011B
Saint Louis, MO 63141-8232

Phone

(314) 569-1750

Fax

(314) 569-3846

NPI assigned

May 25, 2006

Last updated

Oct 2, 2012By 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

Leonard D Gaum, MD

Title

Owner President

Phone

(314) 569-1750

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Luis J Anglo, M.D.

  • Urology Physician
  • Saint Louis, MO
  • NPI 1437112547
  NPD
• Kara Cardinal, PA

  • Physician Assistant
  • Saint Louis, MO
  • NPI 1619065331
  NPD

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349136000000",
    "number": "1700832367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "SUITE 6011B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-569-1750",
            "fax_number": "314-569-3846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "SUITE 6011B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-569-1750",
            "fax_number": "314-569-3846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-COUNTY UROLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2012-10-02",
        "status": "A",
        "authorized_official_last_name": "GAUM",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "314-569-1750",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MO",
            "license": "R4A96",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MO",
            "license": "103702",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201244514",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mid-America Pathology Consultants, LLC
• Mid-America Surgical Group Inc
• Mid-America Transplant Services
• Mid-America Transplant Services
• Mid-County Dermatology, Inc
• Mid-South Home Care Services, LLC (Empatia Palliative Care)
• Mid-West Podiatry and Associates, L L C
• Mid-West Surgical Incorporation
• Midcounty OB GYN Group Inc
• Paul M Midden, PH.D.

• Urology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Urology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; 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.