Kevin L. Threlkeld, M.D., LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MDR5P58 Issued in MO

Legal business name

KEVIN L. THRELKELD, M.D., LLC

Practice address

204 N Main St
O Fallon, MO 63366-2203

Phone

(636) 240-3420

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Kevin L Threlkeld, MD

Title

Physician Registered Agent

Phone

(636) 390-1854

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570665600000",
    "number": "1023195351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 270003",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631270003",
            "telephone_number": "636-390-1854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 N MAIN ST",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633662203",
            "telephone_number": "636-240-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN L. THRELKELD, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2019-10-10",
        "status": "A",
        "authorized_official_last_name": "THRELKELD",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHYSICIAN REGISTERED AGENT",
        "authorized_official_telephone_number": "636-390-1854",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "MDR5P58",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erika Kennedy, M.ED., LPC
• Martin Gerard Kennedy, PH.D.
• Mark K Keohane, M.D.
• Jeremy M Kertz, DPT
• Katie Kessler, LCSW
• Chaudhary Mobin Khan, MD
• Soheel Ahmad Khan, PHARM.D.
• Ellen Elizabeth Kilkenny
• Austen Taylor Killian, DC
• Megan Kim

• Internal Medicine Physician in O Fallon, MO
• Providers in O Fallon, 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 Oct 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.