SLH Physicians LLC
Organization Active NPI Emergency Medicine Physician · Saint Louis, MO
NPI 1881668051 · NPPES record last updated Jul 28, 2016
Key facts
- NPI
- 1881668051
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- SLH PHYSICIANS LLC
- Practice address
- 3635 Vista Ave
Saint Louis, MO 63110-2539 - Phone
- (314) 577-8000
- Fax
- (314) 577-8003
- NPI assigned
- Feb 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Timothy Adams
- Title
- SVP, Regional Operations Tenet
- Phone
- (469) 893-2563
Member of 3
Practitioners 228
-
Fadee Abu Al Rub, MD
-
Lydia Luisa Archuleta, M.D.
-
Iqra Arshad, MD
-
Aleksandar M. Babic, M.D., PH.D.
-
Jenelle K Bair, APRN, FNP-BC
-
Kelly Elizabeth Ball, RN, NP
-
Zachary Ballek, AGACNP-BC
-
Bahar Bastani, MD
-
Alex S Befeler, MD
-
Jo Ann Benn, NP-C
-
Scott Birdwell, M.D.
-
Amy Rosemarie Brown, FNP-BC
-
Diana Busjra Brown, CRNA
-
Fred R Buckhold III, M.D.
-
Matthew James Buhr, ADULT NP
-
Helene Y Burke, APRN, FNP-C
-
Laurie E. Byrne, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050602000941 | MO | Part B Supplier - Clinic/Group Practice | 9830132653 |
Receives reassigned benefits from 227 practitioners Practice locations: Cape Girardeau, MO; Saint Charles, MO; Saint Louis, MO; Springfield, MO; St Louis, MO |
National Provider Directory
Locations
1723 Broadway St
Ste 120
Cpe Girardeau, MO 63701
Phone (573) 331-4680
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes | ||
| Psychiatry Physician |
2084P0800X |
Addresses
Primary practice location
3635 Vista Ave
Saint Louis, MO 63110-2539
Mailing address
3635 Vista Ave
Saint Louis, MO 63110-2539
Phone (314) 577-8000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DE0426 | Other | MO | RR MEDICARE |
| 507180404 | Medicaid | MO |
NPI Registry JSON
{
"created_epoch": "1139961600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1469664000000",
"number": "1881668051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3635 VISTA AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631102539",
"telephone_number": "314-577-8000",
"fax_number": "314-577-8003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3635 VISTA AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631102539",
"telephone_number": "314-577-8000",
"fax_number": "314-577-8003"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SLH PHYSICIANS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-15",
"last_updated": "2016-07-28",
"status": "A",
"authorized_official_last_name": "ADAMS",
"authorized_official_first_name": "TIMOTHY",
"authorized_official_title_or_position": "SVP, REGIONAL OPERATIONS TENET",
"authorized_official_telephone_number": "469-893-2563",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "DE0426",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "507180404",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
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- Sleep Physicians, LLC
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- SLH Vista, Inc.
- SLH Vista, Inc.
- SLH Vista, Inc.
- SLH Vista, Inc.
- Allison Slijepcevic
All providers in Saint Louis, MO · Emergency Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.