OrganizationActive
St Louis University
NPI 1962614750 · Pediatric Neurodevelopmental Disabilities Physician · Saint Louis, MO
Provider details
- NPI number
- 1962614750
- Entity type
- Organization
- Primary specialty
- Pediatric Neurodevelopmental Disabilities PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Alyce Lanxon, Executive Director(314) 977-6828
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone: (314) 577-5600
Street-level locationGet directions
Mailing address
3545 Lindell Blvd Fl 3
Saint Louis, MO 63103-1020
Other names (DBA / former)
- Doing business as
- Slucare Dept of Pediatric Neurodevelopmental Disabilities
- Doing business as
- Slucare Dept of Pediatric Neurodevelopmental Disabilities
Registry dates
- Enumerated
- 2007-05-04
- Last updated
- 2021-09-21
- Certified
- 2021-09-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.