Weight Loss Clinic, LLC

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

WEIGHT LOSS CLINIC, LLC

Doing business as

Advanced Weight Loss Clinic

Practice address

555 Marshall Dr
Saint Robert, MO 65584-5601

Phone

(573) 336-8746

Fax

(573) 336-8391

NPI assigned

Jan 17, 2013

Last updated

Jan 17, 2013By 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

Mrs. Sara Lee Ann Cassidy

Title

Manager

Phone

(573) 336-8746

Specialties & licenses 1

Addresses

Other names 1

• Advanced Weight Loss Clinic Doing business as

Locations

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

{
    "created_epoch": "1358380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358380800000",
    "number": "1962740589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 MARSHALL DR",
            "city": "SAINT ROBERT",
            "state": "MO",
            "postal_code": "655845601",
            "telephone_number": "573-336-8746",
            "fax_number": "573-336-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 MARSHALL DR",
            "city": "SAINT ROBERT",
            "state": "MO",
            "postal_code": "655845601",
            "telephone_number": "573-336-8746",
            "fax_number": "573-336-8391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEIGHT LOSS CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-17",
        "last_updated": "2013-01-17",
        "status": "A",
        "authorized_official_last_name": "CASSIDY",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "LEE ANN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "573-336-8746",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Weight Loss Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Danielle Vlietstra
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• Mallory B Warren-Brothers, PA-C
• Rachael Waters, RN
• Aaron Jacob Weisberger, D.D.S.
• Stephanie Wells
• Benjamin Eugene Werner, DMD
• Selina West
• Sarah Whitehead, RD

• Health Maintenance Organization in Saint Robert, MO
• Providers in Saint Robert, MO by specialty
• Health Maintenance Organization in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; 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.