NPIMap

Organization Active NPI

St Louis Vasectomy, LLC

  • Urology Physician
  • Saint Louis, MO
National Provider Identifier
1972102143
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
ST LOUIS VASECTOMY, LLC
Practice address
10345 Watson Rd
Saint Louis, MO 63127-1105
Phone
(732) 598-1563
NPI assigned
Oct 20, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Authorized official

Name
Marybeth Dunn
Title
Manager
Phone
(732) 598-1563

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

10345 Watson Rd
Saint Louis, MO 63127-1105

Mailing address

525 Rockwood Parc CT
Eureka, MO 63025-1157
Phone (732) 598-1563

Other identifiers 5

IdentifierTypeStateIssuer
2019024779OtherMOLICENSE
2005020831OtherMOLICENSE
R6E96OtherMOLICENSE
R9H43OtherMOLICENSE
2019024767OtherMOLICENSE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603152000000",
    "number": "1972102143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 ROCKWOOD PARC CT",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251157",
            "telephone_number": "732-598-1563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10345 WATSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271105",
            "telephone_number": "732-598-1563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LOUIS VASECTOMY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A",
        "authorized_official_last_name": "DUNN",
        "authorized_official_first_name": "MARYBETH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "732-598-1563"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2019024779",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2005020831",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "R6E96",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "R9H43",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2019024767",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.