Midwest Urogynecology, LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

2011012595 Issued in MO

Legal business name

MIDWEST UROGYNECOLOGY, LLC

Practice address

2325 Dougherty Ferry Rd Ste 206
Saint Louis, MO 63122-3356

Phone

(314) 596-9955

Fax

(314) 596-9530

NPI assigned

Nov 18, 2015

Organization subpart

No

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

Authorized official

Name

John Judd, MD

Title

Owner

Phone

(314) 596-9955

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1952775751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 DOUGHERTY FERRY RD STE 206",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631223356",
            "telephone_number": "314-596-9955",
            "fax_number": "314-596-9530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 DOUGHERTY FERRY RD STE 206",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631223356",
            "telephone_number": "314-596-9955",
            "fax_number": "314-596-9530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST UROGYNECOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-18",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "JUDD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-596-9955",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2011012595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Obstetrics & Gynecology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.