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EDEN PEDIATRICS LLC
NPI 1659477024
Pediatrics in Saint Louis, MO

Active since September 15, 2006CLIA 26D2192133 · Waiver
763 S NEW BALLAS RD, SUITE 220, SAINT LOUIS, MO 63141(314) 983-0606(314) 983-0608 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Eden Pediatrics Llc NPPES

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

EDEN PEDIATRICS LLC (NPI 1659477024) is a healthcare organization registered as a pediatrics in Saint Louis, Missouri and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through September 3, 2026 and lists Etihad Shakir Al-falahi, President, as its authorized official.

NPPES Registry Identity

NPI1659477024
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameEDEN PEDIATRICS LLC
Location Address763 S NEW BALLAS RD, SUITE 220Saint Louis, MO 63141-8704
Mailing Address763 S New Ballas Rd Ste 220Saint Louis, MO 63141-8711 · (314) 983-0606 · Fax (314) 983-0608
Phone(314) 983-0606
Fax(314) 983-0608
Organization SubpartNo
Authorized OfficialEtihad Shakir Al-falahiPresident · (314) 983-0606
Enumeration DateSeptember 15, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1659477024 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in MO · MD101423
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.
763 S NEW BALLAS RD, Saint Louis, MO 63141
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Other Identifiers 6

Other114721MO · Blue Cross Blue Shield
Other214028MO · Group Health Plan
Other5013620MO · Aetna
OtherG10654MO · Mercy Health Plan
Other1210150MO · United Healthcare
Other286120MO · Healthlink

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D2192133

Eden Pediatrics · Saint Louis, MO
Active · expires Sep 3, 2026
CLIA Number26D2192133
Laboratory TypePhysician Office
Certificate Effective DateSeptember 4, 2024
Certificate Expiration DateSeptember 3, 2026
Laboratory DirectorEtihad Alfalahi
Laboratory Phone(314) 983-0606
Laboratory LocationEden Pediatrics12855 N Outer 40 #240, Saint Louis, MO 63141
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. ERIC SCOTT BAILE M.DIV., MAC
Counselor (Mental Health)
763 S NEW BALLAS RD, SUITE 340
SAINT LOUIS, MO 63141
St. Louis County (314) 872-2972
MONICA GRADY M.A.
Psychologist
763 S NEW BALLAS RD, SUITE 110
SAINT LOUIS, MO 63141
St. Louis County (314) 569-1717
MRS. ROSE GROSSIUS
Nurse Practitioner
763 S NEW BALLAS RD, SUITE 350
SAINT LOUIS, MO 63141
St. Louis County (314) 432-5144
ORTHOMOTION L.L.C.
Durable Medical Equipment & Medical Supplies (Customized Equipment)
763 S NEW BALLAS RD, SUITE 370
SAINT LOUIS, MO 63141
St. Louis County (314) 994-7400
DR. JAGDISH SURI M.D.
Psychiatry & Neurology (Psychiatry)
763 S NEW BALLAS RD, SUITE 110
SAINT LOUIS, MO 63141
St. Louis County (314) 569-1717
DR. SCOTT HAINZ DC
Chiropractor
763 S NEW BALLAS RD, SUITE 230
CREVE COEUR, MO 63141
St. Louis County (314) 681-2800
MR. DOUGLAS J SAMSEL M.A., L.P.C.
Counselor (Professional)
763 S NEW BALLAS RD, SUITE 340
SAINT LOUIS, MO 63141
St. Louis County (314) 872-2972
ELIZABETH NICHOLE LEHMAN PTA
Physical Therapy Assistant
763 S NEW BALLAS RD, 200
SAINT LOUIS, MO 63141
St. Louis County (314) 991-2562

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 Eden Pediatrics LLC's NPI number?

The NPI number for Eden Pediatrics LLC is 1659477024. It was assigned to this organization in the NPPES registry on September 15, 2006.

Where is Eden Pediatrics LLC located?

Eden Pediatrics LLC is located at 763 S New Ballas Rd Suite 220, Saint Louis, MO 63141. The listed phone number is (314) 983-0606.

What is Eden Pediatrics LLC's specialty?

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

Does Eden Pediatrics LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2192133) is associated with this NPI, valid through September 3, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Eden Pediatrics LLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.