St. Louis Spine Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ST. LOUIS SPINE SURGERY CENTER, LLC

Practice address

633 Emerson Rd
Suite 160
Creve Coeur, MO 63141-6739

Phone

(314) 569-2007

NPI assigned

Feb 8, 2012

Organization subpart

No

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

Authorized official

Name

Mr. John Wilson

Title

Chief Financial Officer

Phone

(615) 301-8144

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353888000000",
    "number": "1861764771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 EMERSON RD",
            "address_2": "SUITE 160",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416739",
            "telephone_number": "314-569-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 EMERSON RD",
            "address_2": "SUITE 160",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416739",
            "telephone_number": "314-569-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LOUIS SPINE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-08",
        "last_updated": "2012-11-26",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "615-301-8144",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kayla Kishon Stallings
• Brittany Ryan Staples

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; 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.