NOVAMED EYE SURGERY CENTER OF NORTH COUNTY LLC NPI 1285630160

NPI Information

NPI: 1285630160
Provider Name: NOVAMED EYE SURGERY CENTER OF NORTH COUNTY, LLC

Doing Business As: WOODCREST SURGERY CENTER

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
12101 WOODCREST EXECUTIVE DR
SUITE 101
SAINT LOUIS, MO
ZIP 63141
Phone: (866) 631-7890
Get Directions

NOVAMED EYE SURGERY CENTER OF NORTH COUNTY, LLC is an ambulatory surgical clinic center in Saint Louis, MO. NOVAMED EYE SURGERY CENTER OF NORTH COUNTY, LLC NPI is 1285630160. The provider is registered as an organization entity type.
The provider Is Doing Business As Woodcrest Surgery Center.

The provider's business location address is:

12101 WOODCREST EXECUTIVE DR
SUITE 101
SAINT LOUIS, MO
ZIP 63141-047
Phone: (866) 631-7890
Fax: (314) 838-6532

The provider's authorized official is Jennifer Boyd Baldock .
The authorized official title is Officer And Authorized Official and has the following contact phone number (615) 234-5900.

The CLIA number assigned to this NPI record is 26D0922497 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/24/2005 and was last updated on 3/6/2020.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	76-9	MISSOURI	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	505450205	MEDICAID	MISSOURI
2	490003037	OTHER		RR MEDICARE

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

NPI Synchronization or Removal

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