Thomas Fox Landholt Jr., MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R7J81 Issued in MO

Practice address

19 The Boulevard Saint Louis
Saint Louis, MO 63117-1118

Phone

(314) 354-8810

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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 Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mercy Clinic East Communities

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1851335228

  Family Medicine

  Medicare reassignment NPD
• Patientcare Medical LLC

  • Primary Care Clinic/Center
  • Springfield, MO
  • NPI 1801075650
  NPD (past) Authorized official
• Mercy Clinic East Communities

  • Multi-Specialty Clinic/Center
  • Wildwood, MO
  • NPI 1164857397

  Family Medicine

  NPD
• St. Clair County Hospital District #1

  • Rural Acute Care Hospital
  • Osceola, MO
  • NPI 1588747554
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1033205646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2949 E CHESTNUT EXPRESSWAY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "65802",
            "telephone_number": "417-832-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 THE BOULEVARD SAINT LOUIS",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171118",
            "telephone_number": "314-354-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDHOLT",
        "first_name": "THOMAS",
        "middle_name": "FOX",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R7J81",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202956322",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Bruce Landes, MD
• Gretchen Landgraf, DO
• Kristen Landgraf, MED, LPC
• Thomas J Landgraf, OD
• Olivia Landgrebe, LPC
• Megan Reidy Landis, DO
• Katherine Rose Landmann, NP
• Luke Philip Landolt, DO
• Laurie Ann Landra, PLPC
• Amber Landry

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; 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.