DES PERES SQUARE IMAGING CENTER LLC (NPI# 1134120454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134120454 |
| Entity Type | Organization |
| Organization Name | DES PERES SQUARE IMAGING CENTER LLC |
| Practice Address |
1050 Old Des Peres Rd Suite 75 Saint Louis MO 63131-1873 |
| Mailing Address |
1050 Old Des Peres Rd Suite 100 Saint Louis MO 63131-1873 |
| Practice Telephone | 3145692412 |
| Practice Fax Number | 3145691655 |
| Mailing Telephone | 3145692412 |
| Mailing Fax Number | 3145691655 |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2011-03-09 |
| Authorized Official Name | MR. LARRY W POLLEY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3145690612 |
| Is Organization Subpart | Y |
| Parent Organization Name | ORTHOPEDIC ASSOCIATES LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1200X |
Clinic/Center Specialization: Magnetic Resonance Imaging (MRI) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | HEALTHLINK | 473861 | 01 |
| MO | UNITED HEALTHCARE | 1601575 | 01 |
| MO | ANTHEM | 168483 | 01 |
| MO | MEDICARE RAILROAD PIN | 470001747 | 01 |
| MO | AETNA | 2612904 | 01 |
| Street Address |
1050 OLD DES PERES RD SUITE 75 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63131-1873 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437155314 | Rueschhoff Physical Therapy Inc | Occupational Therapist | 1050 Old Des Peres Rd, Ste 40, Saint Louis, MO 63131-1873 | 2005-06-24 |
| 1740673953 | Manchester Ambulatory Surgery Center Lp | Clinic/Center | 1050 Old Des Peres Rd, Suite 150, Saint Louis, MO 63131-1873 | 2015-03-12 |
| 1093130486 | Angela Grainger Gauthier | Physician Assistant | 1050 Old Des Peres Rd, Suite 100, Saint Louis, MO 63131-1873 | 2014-02-21 |
| 1316236409 | Mohammed Imran Paracha | Anesthesiology | 1050 Old Des Peres Rd, Suite 100, Saint Louis, MO 63131-1873 | 2011-03-29 |
| 1114182169 | Christy Dow | Occupational Therapist | 1050 Old Des Peres Rd, Suite 40, Saint Louis, MO 63131-1873 | 2008-07-18 |
| 1518161355 | Christopher David Mudd | Orthopaedic Surgery | 1050 Old Des Peres Rd, Ste 100, Saint Louis, MO 63131-1873 | 2007-06-14 |
| 1568682375 | Bethanie Dinan | Physician Assistant | 1050 Old Des Peres Rd, Suite 100, Saint Louis, MO 63131-1873 | 2007-04-26 |
| 1912032020 | Orthopedic Associates, LLC | Durable Medical Equipment & Medical Supplies | 1050 Old Des Peres Rd, Suite 100, Saint Louis, MO 63131-1873 | 2007-02-22 |
| 1295888436 | Robert Kramer | Orthopaedic Surgery | 1050 Old Des Peres Rd, Suite 100, Saint Louis, MO 63131-1873 | 2007-01-19 |
| 1144373341 | William Feinstein | Orthopaedic Surgery | 1050 Old Des Peres Rd, Suite 100, Saint Louis, MO 63131-1873 | 2007-01-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568097954 | Avalcare Inc | Pharmacy | 10431 Clayton Rd, Saint Louis, MO 63131 | 2020-03-06 |
| 1891331369 | Life Clinic of Mo Dc PC | Chiropractor | 2051 South Lindbergh Blvd, Frontenac, MO 63131 | 2019-11-20 |
| 1447892542 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 30 S Lindbergh Blvd, Saint Louis, MO 63131 | 2019-10-10 |
| 1336797026 | Justa Davis | Dietitian, Registered | 3015 North Ballas, Saint Louis, MO 63131 | 2019-08-27 |
| 1730695362 | Curators of The University of Missouri | Psychologist | 12837 Flushing Meadows Drive, Sutie 220, Town and Country, MO 63131 | 2017-12-19 |
| 1770012031 | Danielle Marie Hargate | Specialist/Technologist | 732 Timber Trail, Frontenac, MO 63131 | 2017-06-08 |
| 1285087429 | Kathryn Parker | Internal Medicine | 1000 Des Peres Rd Ste 300, Saint Louis, MO 63131 | 2016-07-22 |
| 1437524360 | Julie Ann Godefroid | Nurse Practitioner | 1010 Old Des Peres Road, St. Louis, MO 63131 | 2015-12-03 |
| 1073982435 | Rebecca Baum Rainbolt | Social Worker | 12210 Clayton Rd, Saint Louis, MO 63131 | 2015-09-16 |
| 1518217322 | Advanced Anesthesia and Pain Management, LLC | Anesthesiology | 12805 Topping Woods Estate Drive, St. Louis, MO 63131 | 2012-09-19 |
| Find all providers in zip 63131 | ||||
| Taxonomy Code | 261QM1200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Magnetic Resonance Imaging (MRI) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659325876 | Precision Imaging, LLC | Clinic/Center | 1028 Old Des Peres Rd, Saint Louis, MO 63131-1865 | 2006-05-20 |
| 1538339841 | Tesson Heights Orthopedic | Clinic/Center | 12152 Tesson Ferry Rd, Saint Louis, MO 63128-1726 | 2008-03-04 |
| 1790720936 | Open Mri of Missouri, L.L.C. | Clinic/Center | 1034 S Brentwood Blvd, Suite 111, Saint Louis, MO 63117-1223 | 2006-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750583423 | Team Diagnostics LLC | Clinic/Center | 102 C. Progress Drive, Sullivan, MO 63080-2359 | 2007-06-04 |
| 1598841140 | Mri of Springfield, Inc | Clinic/Center | 1420 E Bradford Pkwy, Springfield, MO 65804-6563 | 2006-10-27 |
| 1437253754 | Cyber Diagnostic Medicine LLC | Clinic/Center | 11901 W Florissant Ave, Florissant, MO 63033-6778 | 2006-09-08 |
| 1679688360 | Rivercity Imaging | Clinic/Center | 623 S Silver Springs Rd Ste 720, Cape Girardeau, MO 63703-7500 | 2006-08-20 |
| 1073522801 | Big Bend Imaging, LLC | Clinic/Center | 1001 S Kirkwood Rd Ste 110, Kirkwood, MO 63122-7250 | 2006-08-08 |
| 1730124918 | Open Mri of Missouri II, L.L.C. | Clinic/Center | 5650 Mexico Rd, Suite 10, Saint Peters, MO 63376-1696 | 2006-06-19 |
| 1407845472 | Poplar Bluff Medical Partners, LLC | Clinic/Center | 221 Physicians Park, Poplar Bluff, MO 63901-3956 | 2005-10-20 |
| 1508869397 | Open Mri of Missouri II LLC | Clinic/Center | 3431 S Hwy 291, Independence, MO 64057-2341 | 2005-05-24 |
| 1548685753 | Spero Medical Imaging LLC | Clinic/Center | 17020 E Us Highway 40, Suite 4, Independence, MO 64055-5361 | 2014-02-25 |
| 1225466691 | Alpha Medical Imaging Inc | Clinic/Center | 5650 Mexico Rd, Suite 15, Saint Peters, MO 63376-1696 | 2013-10-23 |
| Find all providers with the same taxonomy | ||||
| City | SAINT LOUIS |
| Zip Code | 63131 |
Please comment or provide details below to improve the information on DES PERES SQUARE IMAGING CENTER LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.