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YOUR VILLAGE STL LLC
NPI 1205552643
Pediatrics in Wildwood, MO

Active since October 18, 2022
1719 BIG HORN BASIN DR, WILDWOOD, MO 63011(314) 753-3982 Get Directions Write a Review

NPPES record last updated: October 18, 2022. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Your Village Stl Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

YOUR VILLAGE STL LLC (NPI 1205552643) is a healthcare organization registered as a pediatrics in Wildwood, Missouri and active in the NPI registry since October 2022. The organization lists Jennifer Tietjen, Owner, as its authorized official.

NPPES Registry Identity

NPI1205552643
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameYOUR VILLAGE STL LLC
Location Address1719 BIG HORN BASIN DRWildwood, MO 63011-4821
Mailing Address1719 Big Horn Basin DrWildwood, MO 63011-4821 · (314) 753-3982
Phone(314) 753-3982
Organization SubpartNo
Authorized OfficialJennifer TietjenOwner · (314) 753-3982
Enumeration DateOctober 18, 2022
NPPES CertifiedOctober 18, 2022
✔ NPI 1205552643 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1719 BIG HORN BASIN DR, Wildwood, MO 63011
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Your Village Stl LLC's NPI number?

The NPI number for Your Village Stl LLC is 1205552643. It was assigned to this organization in the NPPES registry on October 18, 2022.

Where is Your Village Stl LLC located?

Your Village Stl LLC is located at 1719 Big Horn Basin Dr, Wildwood, MO 63011. The listed phone number is (314) 753-3982.

What is Your Village Stl LLC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

When was this NPI record last updated?

The NPPES record for Your Village Stl LLC was last updated on October 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.