Healthcare Provider Details

I. General information

NPI: 1629931605
Provider Name (Legal Business Name): SSM HEALTH SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 N NEW BALLAS CT STE 100
CREVE COEUR MO
63141-7169
US

IV. Provider business mailing address

845 N NEW BALLAS CT STE 100
CREVE COEUR MO
63141-7169
US

V. Phone/Fax

Practice location:
  • Phone: 417-447-4484
  • Fax:
Mailing address:
  • Phone: 417-447-4484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBERT MCCARVILLE
Title or Position: ADMINISTRATOR
Credential:
Phone: 417-889-2040