Metro St. Louis Dialysis - Florissant LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

METRO ST. LOUIS DIALYSIS - FLORISSANT LLC

Practice address

10160 W Florissant Ave
Saint Louis, MO 63136-2104

Phone

(314) 869-4978

Fax

(314) 869-5098

NPI assigned

Dec 18, 2006

Organization subpart

No

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

Authorized official

Name

Keisha Denise Greene

Title

VP of Clinical & Regulatory

Phone

(978) 522-3905

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660780800000",
    "number": "1942363320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10160 W FLORISSANT AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631362104",
            "telephone_number": "314-869-4978",
            "fax_number": "314-869-5098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10160 W FLORISSANT AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631362104",
            "telephone_number": "314-869-4978",
            "fax_number": "314-869-5098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO ST. LOUIS DIALYSIS - FLORISSANT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "KEISHA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "VP OF CLINICAL & REGULATORY",
        "authorized_official_telephone_number": "978-522-3905"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "506121102",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Metro Medical Clinic, LLC
• Metro Medical Institute
• Metro Saint Louis Dialysis Center
• Metro St Louis Renal Services, Inc
• Metro St Louis Surgery Center LLC
• Metro Urgent Care LLC
• Metropolitan Neurology, LTD
• Metropolitan Orthopedics, LTD.
• Metropolitan Physicians Group LLC
• Metropolitan Speech and Language Center

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.