The Surgery Center of St. Louis, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

129-2 Issued in MO

Legal business name

THE SURGERY CENTER OF ST. LOUIS, LLC

Practice address

12639 Old Tesson Rd
Suite 130
Saint Louis, MO 63128-2786

Phone

(314) 729-0785

Fax

(314) 849-4637

NPI assigned

Nov 6, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Michael Ladevich

Title

Ceo

Phone

(314) 842-8655

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208131200000",
    "number": "1710066014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12639 OLD TESSON RD",
            "address_2": "SUITE 130",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282786",
            "telephone_number": "314-729-0785",
            "fax_number": "314-849-4637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12639 OLD TESSON RD",
            "address_2": "SUITE 130",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282786",
            "telephone_number": "314-729-0785",
            "fax_number": "314-849-4637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SURGERY CENTER OF ST. LOUIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2008-04-14",
        "status": "A",
        "authorized_official_last_name": "LADEVICH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "314-842-8655",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MO",
            "license": "129-2",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "490005357",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Soulard School
• The Speech Station
• The Spirit of Love Home Health Services LLC
• The St Louis Mo Orthopaedic ASC LLC
• The State of the Art Adult Healthcare Centre
• The Therapy Project
• The War Room
• The Wellness Partnership Group LLC
• The Whiteville Drugstore, LLC
• The Whole You Wellness and Counseling Center LLC

• Ambulatory Surgical Clinic/Center in Saint Louis, MO
• Providers in Saint Louis, 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 Apr 14, 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.