Connor Robert Reis, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2023023726 Issued in MO

Practice address

615 S New Ballas Rd
Saint Louis, MO 63141-8221

Phone

(314) 251-6930

NPI assigned

Apr 17, 2023

Last updated

Jun 29, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1003502527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 3019B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418267",
            "telephone_number": "314-509-5305",
            "fax_number": "314-251-4454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-6930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIS",
        "first_name": "CONNOR",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-17",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2023023726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Joseph Reinhart
• Brian Davis Reinholz, MD
• Angela Mary Reining, MD
• Donald Reinke, MD
• Celine Noelle Reinoso, MSW, LMSW
• Martha Jacqueline Reis
• Martin Nicholas Reis, MD
• Megan Jae Reis, OTR
• Emily Suzanne Reisenbichler, M.D.
• Jeffrey D Reiser, PHARM.D.

• Internal Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.