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MASON RIDGE AMBULATORY SURGERY CENTER LP NPI 1821133133


NPI Information

NPI: 1821133133
Provider Name: MASON RIDGE AMBULATORY SURGERY CENTER, LP

Doing Business As: MASON RIDGE SURGERY CENTER

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

Specialization: Ambulatory Surgical

Address:
12855 N 40 DR
STE 100
SAINT LOUIS, MO
ZIP 63141
Phone: (314) 878-7150
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MASON RIDGE AMBULATORY SURGERY CENTER, LP is an ambulatory surgical clinic center in Saint Louis, MO. MASON RIDGE AMBULATORY SURGERY CENTER, LP NPI is 1821133133. The provider is registered as an organization entity type.
The provider Is Doing Business As Mason Ridge Surgery Center.

The provider's business location address is:

12855 N 40 DR
STE 100
SAINT LOUIS, MO
ZIP 63141-657
Phone: (314) 878-7150
Fax: (314) 878-3051

The provider's authorized official is Katherine L Reed .
The authorized official title is Officer, Authorized Official and has the following contact phone number (972) 763-3859.

The enumeration date for this NPI number is 2/21/2007 and was last updated on 8/26/2014.


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
1261QA1903XClinic/CenterAmbulatory Surgical201-7MISSOURIYes

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
1204703OTHERMISSOURIBLUE CROSS BLUE SHIELD
2500092309MEDICAIDMISSOURI
3000040103MEDICARE PINMISSOURI
426C0001111MEDICARE OSCAR/CERTIFICATIONMISSOURI

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.