St. Louis Surgical Doctors Group, LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

ST. LOUIS SURGICAL DOCTORS GROUP, LLC

Practice address

3535 S Jefferson Ave
Ste 201
Saint Louis, MO 63118-3930

Phone

(314) 577-5778

NPI assigned

Aug 12, 2008

Last updated

Aug 12, 2008By 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

Anil SrivastavaNPI 1205920220

Title

Owner

Phone

(314) 508-1152

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Anil Kumar Srivastava, MD

  • Surgery Physician
  • Bridgeton, MO
  • NPI 1205920220
  NPD (past) Authorized official

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218499200000",
    "number": "1891941712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "548 CLAYMONT PLACE DR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630112553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 S JEFFERSON AVE",
            "address_2": "STE 201",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631183930",
            "telephone_number": "314-577-5778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LOUIS SURGICAL DOCTORS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-12",
        "last_updated": "2008-08-12",
        "status": "A",
        "authorized_official_last_name": "SRIVASTAVA",
        "authorized_official_first_name": "ANIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-508-1152"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; 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.