CHESTERFIELD PEDIATRICS NPI 1629285176

NPI Information

  • NPI: 1629285176
  • Provider Name: CHESTERFIELD PEDIATRICS
  • Classification: Pediatrics - 2080A0000X
  • Specialization: Adolescent Medicine
  • Entity Type: Organization
  • CLIA Number: 26D0437204
  • Address: 16216 BAXTER ROAD
    SUITE 310
    CHESTERFIELD, MO
    ZIP 63017
  • Phone: (636) 519-8899

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NPI Details

CHESTERFIELD PEDIATRICS is an adolescent medicine pediatrics in Chesterfield, MO. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. CHESTERFIELD PEDIATRICS NPI is 1629285176. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

16216 BAXTER ROAD
SUITE 310
CHESTERFIELD, MO
ZIP 63017
Phone: (636) 519-8899
Fax: (636) 519-0011

The provider's authorized official is Darryl S Cohen .
The authorized official title is President and has the following contact phone number (636) 519-8899.

The CLIA number assigned to this NPI record is 26D0437204 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/16/2007 and was last updated on 10/15/2008.

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
12080A0000XPediatricsAdolescent MedicineRIC34MISSOURIYes

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
1501104707MEDICAIDMISSOURI

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: 11/21/2025

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