Ahs Missouri Medical Group LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

AHS MISSOURI MEDICAL GROUP LLC

Practice address

3933 S Broadway
Saint Louis, MO 63118-4601

Phone

(818) 666-0602

NPI assigned

Oct 25, 2022

Last updated

Oct 25, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jonathan E Burket

Title

Compliance

Phone

(818) 666-0602

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666656000000",
    "number": "1841917309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N BRAND BLVD STE 1110",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912033932",
            "telephone_number": "818-666-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3933 S BROADWAY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631184601",
            "telephone_number": "818-666-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AHS MISSOURI MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A",
        "authorized_official_last_name": "BURKET",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "COMPLIANCE",
        "authorized_official_telephone_number": "818-666-0602"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nadia Jemal Ahmedin
• Tyler Michael Aholt, DDS
• Anna M Ahrens, ANP
• Christopher Michael Ahrens, D.O.
• Serena A Ahrens, MS CCC-SLP
• Salman Ahsan, MD
• Anna Marie Aiazzi
• Aidaly Care Missouri LLC (Aidaly Care)
• Kari Aiello, PHARM.D.
• Taylor Aiken

• Clinic/Center in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.