Healthcare Provider Details

I. General information

NPI: 1376166066
Provider Name (Legal Business Name): NHS SOUTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2020
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10004 KENNERLY RD STE 374B
SAINT LOUIS MO
63128-2178
US

IV. Provider business mailing address

PO BOX 802841
KANSAS CITY MO
64180-2841
US

V. Phone/Fax

Practice location:
  • Phone: 314-842-9669
  • Fax: 314-842-1017
Mailing address:
  • Phone: 314-842-9669
  • Fax: 314-842-1017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: KABEYA MWINTSHI
Title or Position: OWNER
Credential: MD
Phone: 314-662-2159