| NPI | 1184679961 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2006-05-23 |
| Last Updated | 2025-04-18 |
| Mailing Address | Po Box 7412035 Chicago, IL 60674-2035 United States Phone: (314) 367-3113 | Fax: (314) 454-9382 📍 View Map |
| Primary Practice Address | 1110 Highlands Plaza Dr E, Ste 375 Saint Louis, MO 63110-1392 United States Phone: (314) 367-3113 | Fax: (314) 454-9382 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | MO | 209809714 | - |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 207R00000X – Internal Medicine | MO | 108667 |
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About NPI 1184679961
Scott P Wasserstrom MD is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1184679961. The primary specialty listed is Internal Medicine. The provider is located in Saint Louis, MO. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-05-23. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1184679961?
NPI 1184679961 belongs to Scott P Wasserstrom MD, a Internal Medicine in Saint Louis, MO. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1184679961 active?
The current status of NPI 1184679961 in the NPPES registry is Active. The record was last updated on 2025-04-18.
What specialty is NPI 1184679961?
NPI 1184679961 is classified under the taxonomy Internal Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1184679961?
You can verify NPI 1184679961 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1184679961?
The primary practice address on file for NPI 1184679961 is 1110 Highlands Plaza Dr E, Saint Louis, MO 63110-1392. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1184679961 issued?
NPI 1184679961 was first issued (enumerated) on 2006-05-23. The NPPES record was last updated on 2025-04-18.
Practice Location Map
Scott P Wasserstrom is located at 1110 Highlands Plaza Dr E, Saint Louis, MO. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Scott P Wasserstrom. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1184679961. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Internal Medicine | 108667 | MO |