Organization Active NPI

STL Surgical LLC

  • Ambulatory Surgical Clinic/Center
  • Bridgeton, MO
National Provider Identifier
1750896635
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
STL SURGICAL LLC
Practice address
12184 Natural Bridge Rd
Bridgeton, MO 63044-2017
Phone
(314) 481-3037
NPI assigned
Dec 13, 2017
Last updated
Feb 13, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2019

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

Authorized official

Name
Kristen Brannon, ADMINISTRATOR
Title
Administrator
Phone
(502) 303-0919

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X NU Primary
Interventional Pain Medicine Physician 208VP0014X NU

Addresses

Primary practice location

12184 Natural Bridge Rd
Bridgeton, MO 63044-2017

Mailing address

5203 Chippewa St Ste 301
Saint Louis, MO 63109-2356
Phone (314) 481-5000

Other practice location 1

5203 Chippewa St Ste 301
Saint Louis, MO 63109-2356
Phone (314) 481-3037

National Provider Directory

National Provider Directory

Locations

12184 Natural Bridge Rd
Bridgeton, MO 63044
Phone (314) 481-3037

NPI Registry JSON

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

{
    "created_epoch": "1513123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550016000000",
    "number": "1750896635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5203 CHIPPEWA ST STE 301",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631092356",
            "telephone_number": "314-481-5000",
            "fax_number": "314-481-3037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12184 NATURAL BRIDGE RD",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442017",
            "telephone_number": "314-481-3037"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5203 Chippewa St Ste 301",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631092356",
            "country_code": "US",
            "telephone_number": "314-481-3037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "STL SURGICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-13",
        "last_updated": "2019-02-13",
        "status": "A",
        "authorized_official_last_name": "BRANNON",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "502-303-0919",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2019; 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.