Missouri Imaging Affiliates LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MISSOURI IMAGING AFFILIATES LLC

Doing business as

Clinical PET of West County

Practice address

450 N New Ballas Rd
Creve Coeur, MO 63141-6835

Phone

(314) 567-4343

Fax

(314) 567-4346

NPI assigned

Sep 19, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Steven Michael McRae

Title

Managing Member

Phone

(618) 659-1167

Specialties & licenses 1

Addresses

Other names 1

• Clinical PET of West County Doing business as

Locations

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841285558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 868",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620250868",
            "telephone_number": "618-659-1167",
            "fax_number": "618-659-1197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N NEW BALLAS RD",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416835",
            "telephone_number": "314-567-4343",
            "fax_number": "314-567-4346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI IMAGING AFFILIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCRAE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "618-659-1167",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinical PET of West County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lauren Minden
• Mindful Change STL LLC
• Minimed Distribution Corp.
• Carol Ruth Mischnick, M.D.
• Missouri CVS Pharmacy, L.L.C.
• Missouri Pain Specialists, LLC
• Missouri Professional Staffing Service Home Health Inc
• Lauren L Mitchell, PTA
• Modern Vascular of St Louis LLC
• Kathleen M Monzyk, PT

• Clinic/Center in Creve Coeur, MO
• Providers in Creve Coeur, MO by specialty
• Clinic/Center in Missouri

• 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.