NPIMap

Organization Active NPI

Faris Al-Gebory MD LLC

  • Surgery Physician
  • Fenton, MO
National Provider Identifier
1891025615
Registry record updated Dec 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2008032789 Issued in MO
Legal business name
FARIS AL-GEBORY MD LLC
Practice address
1011 Bowles Ave
Suite 415
Fenton, MO 63026-2395
Phone
(636) 717-1700
NPI assigned
Dec 29, 2009
Last updated
Dec 29, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2009

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

Authorized official

Name
Dr. Faris Al-Gebory, M.D.
Title
Owner/President
Phone
(636) 717-1700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2008032789 MO Primary

Addresses

Primary practice location

1011 Bowles Ave
Suite 415
Fenton, MO 63026-2395

Mailing address

11517 Tivoli LN
Saint Louis, MO 63146-3539
Phone (636) 717-1700

National Provider Directory

National Provider Directory

Locations

1011 Bowles Ave
Ste 415
Fenton, MO 63026
Phone (314) 445-7367

12401 Olive Blvd
Ste 100
Saint Louis, MO 63141
Phone (314) 275-7300

2325 Dougherty Ferry Rd
Ste 204
Saint Louis, MO 63122
Phone (314) 290-7501

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1262044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262044800000",
    "number": "1891025615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11517 TIVOLI LN",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463539",
            "telephone_number": "636-717-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 BOWLES AVE",
            "address_2": "SUITE 415",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262395",
            "telephone_number": "636-717-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARIS AL-GEBORY MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-29",
        "last_updated": "2009-12-29",
        "status": "A",
        "authorized_official_last_name": "AL-GEBORY",
        "authorized_official_first_name": "FARIS",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "636-717-1700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2008032789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2009; 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.