Mattis Road Surgery Center LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

MATTIS ROAD SURGERY CENTER LLC

Practice address

5139 Mattis Rd Ste 100
Saint Louis, MO 63128-2250

Phone

(314) 952-8001

NPI assigned

Sep 9, 2025

Organization subpart

No

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

Authorized official

Name

John Kessler

Title

Administrator

Phone

(314) 952-8001

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1757376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757376000000",
    "number": "1720969504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5139 MATTIS RD STE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282250",
            "telephone_number": "314-952-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5139 MATTIS RD STE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282250",
            "telephone_number": "314-952-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTIS ROAD SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-09",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A",
        "authorized_official_last_name": "KESSLER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "314-952-8001"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dustan J. Mattingly, D.C.
• Lauren Drbul Mattingly, PNP
• Maureen Ann Mattingly, M.S., CCC-SLP
• Tori Marie Mattingly, FNP
• Mattis Road Counseling, LLC
• Ross Mattox, D.C.
• Consuelo Maturana, LPC
• George M. Matuschak, M.D.
• Rachel Ann Matusiak, M.S., R.D., L.D.
• Sydney Lauren Matusik, PA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; 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.