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MERCY CLINIC NEUROLOGY LLC NPI 1053479188


NPI Information

NPI: 1053479188
Provider Name: MERCY CLINIC NEUROLOGY, LLC

Former Legal Business Name: MERCY NEUROLOGY, LLC

Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

Address:
621 S NEW BALLAS RD
SUITE 6005-B
SAINT LOUIS, MO
ZIP 63141
Phone: (314) 251-6075
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MERCY CLINIC NEUROLOGY, LLC is a neurology psychiatry neurology in Saint Louis, MO. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. MERCY CLINIC NEUROLOGY, LLC NPI is 1053479188. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Mercy Neurology, Llc.

The provider's business location address is:

621 S NEW BALLAS RD
SUITE 6005-B
SAINT LOUIS, MO
ZIP 63141-232
Phone: (314) 251-6075
Fax: (314) 251-6634

The provider's authorized official is John W. Hubert .
The authorized official title is President and has the following contact phone number (314) 251-1700.

The enumeration date for this NPI number is 12/4/2006 and was last updated on 3/4/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084N0400XPsychiatry & NeurologyNeurologyMISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11053479188MEDICAIDMISSOURI
2000015210MEDICARE PINMISSOURI
3DO0017OTHERMISSOURIRAILROAD MEDICARE
4MA4200MEDICARE PINMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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