MEDICARE: BJC OUTPATIENT IMAGING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1538016126
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BJC OUTPATIENT IMAGING LLC

Provider Business Mailing Address
First Line	:	800 CRESCENT CENTRE DR STE 400
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-7270
Country	:	US
Telephone Number	:	615-261-2306
Fax Number	:

Provider Business Practice Location Address
First Line	:	2299 TECHNOLOGY DR STE 110
Second Line	:
City	:	O FALLON
State	:	MO
Zip	:	63368-7342
Country	:	US
Telephone Number	:	636-681-1540
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	AMY STOUT
Credential	:
Telephone Number	:	615-261-2306

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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Directions to “BJC OUTPATIENT IMAGING LLC ” Practice Location

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