Unknown Individual – Pediatrics Physician, NPI 1356416754

Unknown Individual is a healthcare provider. based in St louis, Missouri. specializing in Pediatrics Physician. They hold a License No. 32424 (MO). The NPI Number for Unknown Individual is 1356416754

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1356416754
Phone
(314) 567-9190
Address
777 SO NEW BALLAS ROAD
Deactivation Date
10 January 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 777 SO NEW BALLAS ROAD

    SUITE 223W

    ST LOUIS, MO 63141

    Phone: (314) 567-9190

    Fax: (314) 567-9190

    Type: Mailing

  • 777, South New Ballas Road, Town and Country, Saint Louis County, Missouri, 63141, United States

    SUITE 223W

    ST LOUIS, MO 63141

    Phone: (314) 567-9190

    Fax: (314) 567-9191

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63141)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1356416754?
NPI 1356416754 belongs to Unknown Individual; compare other details if you need extra assurance.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Pediatrics Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on St Louis, Missouri.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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