NPIMap

Organization Active NPI

Viking Anesthesia Services, LLC

  • Anesthesiology Physician
  • Creve Coeur, MO
National Provider Identifier
1962809244
Registry record updated Feb 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
104661 Issued in MO
Legal business name
VIKING ANESTHESIA SERVICES, LLC
Practice address
425 N New Ballas Rd
Suite 205
Creve Coeur, MO 63141-6814
Phone
(314) 692-8411
NPI assigned
Dec 2, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2015

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

Authorized official

Name
Dr. Michael Ryan, M.D.NPI 1407966559
Title
Owner
Phone
(314) 692-8411

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X 104661 MO Primary

Addresses

Primary practice location

425 N New Ballas Rd
Suite 205
Creve Coeur, MO 63141-6814

Mailing address

425 N New Ballas Rd
Suite 205
Creve Coeur, MO 63141-6814
Phone (314) 692-8411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150210000198 MO Part B Supplier - Clinic/Group Practice 8628393972 Receives reassigned benefits from 26 practitioners
Practice locations: Creve Coeur, MO; Saint Peters, MO; Wentzville, MO

National Provider Directory

National Provider Directory

Locations

425 N New Ballas Rd
Ste 205
Creve Coeur, MO 63141
Phone (314) 692-8411

5200 Executive Centre Pkwy
Saint Peters, MO 63376
Phone (636) 255-8750

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1417478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423526400000",
    "number": "1962809244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 N NEW BALLAS RD",
            "address_2": "SUITE 205",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416814",
            "telephone_number": "314-692-8411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N NEW BALLAS RD",
            "address_2": "SUITE 205",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416814",
            "telephone_number": "314-692-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIKING ANESTHESIA SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-02",
        "last_updated": "2015-02-10",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-692-8411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "104661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Creve Coeur, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.