NPIMap

Organization Active NPI

Internal Medicine at Winghaven LLC

  • Primary Care Clinic/Center
  • O'Fallon, MO
National Provider Identifier
1033350541
Registry record updated Dec 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
R8F27 Issued in MO
Legal business name
INTERNAL MEDICINE AT WINGHAVEN LLC
Practice address
5551 Winghaven Blvd Ste 290
O Fallon, MO 63368-3629
Phone
(636) 695-2575
Fax
(314) 590-5938
NPI assigned
Mar 12, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2017

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

Authorized official

Name
Rick Sonne
Title
Director
Phone
(314) 576-2490

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X R8F27 MO Primary

Addresses

Primary practice location

5551 Winghaven Blvd Ste 290
O Fallon, MO 63368-3629

Mailing address

5551 Winghaven Blvd Ste 290
O Fallon, MO 63368-3629
Phone (636) 695-2575

National Provider Directory

National Provider Directory
Tax ID family
Internal Medicine at Winghaven LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5551 Winghaven Blvd
Ste 290
O Fallon, MO 63368
Phone (636) 561-6011

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1236816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512432000000",
    "number": "1033350541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5551 WINGHAVEN BLVD STE 290",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633683629",
            "telephone_number": "636-695-2575",
            "fax_number": "314-590-5938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5551 WINGHAVEN BLVD STE 290",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633683629",
            "telephone_number": "636-695-2575",
            "fax_number": "314-590-5938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE AT WINGHAVEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-12",
        "last_updated": "2017-12-05",
        "status": "A",
        "authorized_official_last_name": "SONNE",
        "authorized_official_first_name": "RICK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "314-576-2490"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MO",
            "license": "R8F27",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2017; 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.