SPS PRACTICE GROUP, LLC – NPI #1053046888
Plastic Surgery

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

SPS PRACTICE GROUP, LLC is a plastic surgeon located in COLUMBIA, MO. NPPES has assigned the NPI number 1053046888 to SPS PRACTICE GROUP, LLC on July 17, 2022. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 208200000X from the Health Care Provider Taxonomy code set, which is classified as Plastic Surgery.

The NPI profile was previously updated about 3 years ago on Aug 15, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SPS PRACTICE GROUP, LLC below.

NPI Profile for
SPS PRACTICE GROUP, LLC

NPI Number
1053046888
Enumeration Date

(about 4 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SPS PRACTICE GROUP, LLC
Primary location
3220 BLUFF CREEK DR
COLUMBIA, MO 65201-3663
Phone: (573) 690-6129 Fax:
Mailing address
3220 BLUFF CREEK DR STE 107
COLUMBIA, MO 65201-3664
Phone: (573) 224-8200 Fax: (573) 224-8026
Organization Subpart
No
Authorized Official
LESLIE SHOCK
OWNER
Phone: (573) 224-8200
Updated
Certification Date
Jan 05, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for SPS PRACTICE GROUP, LLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherNPIMO1053046888
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208200000X
- Plastic Surgery (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.