Olde Cabin Anesthesia

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

OLDE CABIN ANESTHESIA

Practice address

11525 Olde Cabin Rd Ste 101
Creve Coeur, MO 63141-7146

Phone

(314) 400-9999

NPI assigned

Oct 29, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Leonard B Weinstock, MDNPI 1467566703

Title

Medical Director

Phone

(314) 400-9999

Specialties & licenses 2

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Advanced Endoscopy Center LLC

  • Ambulatory Surgical Clinic/Center
  • Creve Coeur, MO
  • NPI 1831180272

  Member Of

  NPD member

Practitioners 1

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

• Leonard B Weinstock, MD

  • Gastroenterology Physician
  • Creve Coeur, MO
  • NPI 1467566703
  NPD (past) Authorized official

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593561600000",
    "number": "1780228155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5393",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601975393",
            "telephone_number": "888-337-3509",
            "fax_number": "941-328-3997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11525 OLDE CABIN RD STE 101",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417146",
            "telephone_number": "314-400-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLDE CABIN ANESTHESIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-29",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A",
        "authorized_official_last_name": "WEINSTOCK",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "314-400-9999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Yates Nuckols, PA-C
• Nurses on Duty LLC
• Jordyn O'Neil, AUD
• Kimberly Obholz, OT
• Michael John Oconnell, DMD LLC
• Olive Ambulatory Surgery Center, LLC
• Olive Ambulatory Surgery Center, LLC
• Olive Street Pharmacy LLC
• Olive Surgery Center
• Thomas V Olivier, MD

• Anesthesiology Physician in Creve Coeur, MO
• Providers in Creve Coeur, MO by specialty
• Anesthesiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; 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.