| St Louis Pain Center Llc | |
|
5682 Telegraph Rd Saint Louis MO 63129-4243 | |
| (314) 846-2100 | |
| (314) 846-4975 |
| Full Name | St Louis Pain Center Llc |
|---|---|
| Speciality | Integrative Medicine |
| Location | 5682 Telegraph Rd, Saint Louis, Missouri |
| Authorized Official Name and Position | Andrew Morninstar (OWNER) |
| Authorized Official Contact | 3148462100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Louis Pain Center Llc 5682 Telegraph Rd Saint Louis MO 63129-4243 Ph: (314) 846-2100 | St Louis Pain Center Llc 5682 Telegraph Rd Saint Louis MO 63129-4243 Ph: (314) 846-2100 |
| NPI Number | 1992587968 |
|---|---|
| Provider Enumeration Date | 10/16/2023 |
| Last Update Date | 10/16/2023 |
| Medicare PECOS PAC ID | 2466809645 |
|---|---|
| Medicare Enrollment ID | O20231109000774 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992587968 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 202D00000X | Integrative Medicine | (* (Not Available)) | Primary |
| Provider Name | Kathleen Delain Decker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780168823 PECOS PAC ID: 9931507175 Enrollment ID: I20211001001982 |
| Provider Name | Anissa Wheeler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467059972 PECOS PAC ID: 3072990845 Enrollment ID: I20220517000695 |
| Provider Name | Kay Michelle Seemiller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568180289 PECOS PAC ID: 2062885775 Enrollment ID: I20230228001963 |
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