St Louis Specialty Surgical Center LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

2014001570 Issued in MO

Legal business name

ST LOUIS SPECIALTY SURGICAL CENTER LLC

Practice address

1028 S Kirkwood Rd
Kirkwood, MO 63122-7222

Phone

(314) 394-2950

Fax

(314) 394-2953

NPI assigned

Aug 26, 2016

Last updated

Aug 26, 2016By 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

Mr. David Russell Horace

Title

Administrator

Phone

(618) 973-8740

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.

• Andre P Bouhasin, MD

  • Interventional Cardiology Physician
  • Farmington, MO
  • NPI 1508808635
  NPD

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

{
    "created_epoch": "1472169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472169600000",
    "number": "1962958389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 S KIRKWOOD RD",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631227222",
            "telephone_number": "314-394-2950",
            "fax_number": "314-394-2953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 S KIRKWOOD RD",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631227222",
            "telephone_number": "314-394-2950",
            "fax_number": "314-394-2953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LOUIS SPECIALTY SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-26",
        "last_updated": "2016-08-26",
        "status": "A",
        "authorized_official_last_name": "HORACE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "618-973-8740",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2014001570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Sperry, PT
• Sydney Spier
• Sharon Lee Spruell, LPC
• SSM Cardiovascular and Thoracic Services, Inc.
• St Agnes Home
• St. Anthony's Physician Organization (Mercy Clinic South Physicians)
• St. Louis Cardiovascular Institute, LLC
• St. Louis Cardiovascular Institute, LLC
• St. Louis County Dental Partnership, Timothy M Grayem DDS & Associates
• St. Louis Eating Recovery Therapy, LLC

• Certified Registered Nurse Anesthetist in Kirkwood, MO
• Providers in Kirkwood, MO by specialty
• Certified Registered Nurse Anesthetist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2016; 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.