Organization Active NPI

Florissant Valley Surgical Specialists

  • Colon & Rectal Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1790876027
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
105535 Issued in MO
Legal business name
FLORISSANT VALLEY SURGICAL SPECIALISTS
Practice address
11125 Dunn Rd
Suite 402
Saint Louis, MO 63136-6132
Phone
(314) 741-3400
NPI assigned
Sep 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Morin Hanson, M.D.
Title
Owner
Phone
(314) 741-3400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208C00000X 105535 MO Primary

Addresses

Primary practice location

11125 Dunn Rd
Suite 402
Saint Louis, MO 63136-6132

Mailing address

11125 Dunn Rd
Suite 402
Saint Louis, MO 63136-6132

National Provider Directory

National Provider Directory

Locations

11125 Dunn Rd
Ste 402
Saint Louis, MO 63136
Phone (314) 454-7177

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790876027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11125 DUNN RD",
            "address_2": "SUITE 402",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11125 DUNN RD",
            "address_2": "SUITE 402",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366132",
            "telephone_number": "314-741-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORISSANT VALLEY SURGICAL SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "MORIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-741-3400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": "MO",
            "license": "105535",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 22, 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.