NPIMap

Organization Active NPI

Saint Louis University Hospital- Dept of Neurosurgery

  • Neurological Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1710204995
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
SAINT LOUIS UNIVERSITY HOSPITAL- DEPT OF NEUROSURGERY
Practice address
3655 Vista Ave
Saint Louis, MO 63110-2539
Phone
(314) 977-4440
NPI assigned
Apr 27, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Authorized official

Name
Alyce Lanxon
Title
Executive Director
Phone
(314) 977-6828

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X 2010003185 MO
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

3655 Vista Ave
Saint Louis, MO 63110-2539

Mailing address

3545 Lindell Blvd FL 3
Saint Louis, MO 63103-1020
Phone (314) 577-8849

Other practice location 1

3635 Vista Ave
Grand Blvd
Saint Louis, MO 63110-2539
Phone (314) 577-8849

Other identifiers 1

IdentifierTypeStateIssuer
2010003185OtherMOMISSOURI MEDICAL LICENSE

National Provider Directory

National Provider Directory
Tax ID family
Slucare Dept of Neuro S16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1272326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632182400000",
    "number": "1710204995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3545 LINDELL BLVD FL 3",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631031020",
            "telephone_number": "314-577-8849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3655 VISTA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102539",
            "telephone_number": "314-977-4440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3635 Vista Ave",
            "address_2": "Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631102539",
            "country_code": "US",
            "telephone_number": "314-577-8849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SAINT LOUIS UNIVERSITY HOSPITAL- DEPT OF NEUROSURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-27",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A",
        "authorized_official_last_name": "LANXON",
        "authorized_official_first_name": "ALYCE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "314-977-6828"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "MO",
            "license": "2010003185",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI MEDICAL LICENSE",
            "identifier": "2010003185",
            "state": "MO"
        }
    ],
    "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 Sep 21, 2021; 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.