Organization Active NPI

County Obstetrics & Gynecology, Inc

  • Obstetrics & Gynecology Physician
  • Fenton, MO
National Provider Identifier
1760668941
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
COUNTY OBSTETRICS & GYNECOLOGY, INC
Practice address
1859 Bowles Ave Ste 103
Fenton, MO 63026-1944
Phone
(636) 680-1961
Fax
(636) 680-1964
NPI assigned
Jan 17, 2008
Last updated
Dec 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Authorized official

Name
Dr. Lawrence Vincent Boveri, MDNPI 1003841388
Title
Physician
Phone
(636) 680-1961

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X Primary

Addresses

Primary practice location

1859 Bowles Ave Ste 103
Fenton, MO 63026-1944

Mailing address

1859 Bowles Ave Ste 103
Fenton, MO 63026-1944
Phone (636) 680-1961

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090821000589 MO Part B Supplier - Clinic/Group Practice 2769536929 Receives reassigned benefits from 3 practitioners
Practice locations: Fenton, MO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D0439363County Obstetrics and Gynecology, Inc1859 Bowles Ave Suite 103, Fenton, MO 63026Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory

Locations

1859 Bowles Ave
Ste 103
Fenton, MO 63026
Phone (636) 680-1960

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1200528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734393600000",
    "number": "1760668941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1859 BOWLES AVE STE 103",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630261944",
            "telephone_number": "636-680-1961",
            "fax_number": "636-680-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1859 BOWLES AVE STE 103",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630261944",
            "telephone_number": "636-680-1961",
            "fax_number": "636-680-1964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OBSTETRICS & GYNECOLOGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-17",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A",
        "authorized_official_last_name": "BOVERI",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "VINCENT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "636-680-1961",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.