Physician Groups LC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PHYSICIAN GROUPS LC

Practice address

3009 N Ballas Rd
Suite 315a
Saint Louis, MO 63131-2322

Phone

(314) 996-5900

Fax

(314) 996-5910

NPI assigned

Nov 28, 2006

Organization subpart

No

Name

Raymond P Davidson II, MD

Title

President

Phone

(314) 286-2028

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Physician Groups LC

  • Medical Specialty Clinic/Center
  • Saint Peters, MO
  • NPI 1003982182

  O20040220001157

  Same enrollment
• Physician Groups LC

  • Urgent Care Clinic/Center
  • Columbia, MO
  • NPI 1033285135

  O20040220001157

  Same enrollment
• Physician Groups LC

  • Primary Care Clinic/Center
  • Florissant, MO
  • NPI 1043386162

  O20040220001157

  Same enrollment
• Physician Groups LC

  • Obstetrics & Gynecology Physician
  • Saint Peters, MO
  • NPI 1043403009

  O20040220001157

  Same enrollment
• Physician Groups LC

  • Primary Care Clinic/Center
  • Saint Louis, MO
  • NPI 1053487132

  O20040220001157

  Same enrollment
• Physician Groups LC

  • Medical Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1124194212

  O20040220001157

  Same enrollment
• Physician Groups LC

  • Medical Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1124194360

  O20040220001157

  Same enrollment
• Physician Groups LC

  • Family Medicine Physician
  • Weldon Spring, MO
  • NPI 1144357278

  O20040220001157

  Same enrollment
• Physician Groups LC

  • Surgery Physician
  • O'Fallon, MO
  • NPI 1164553590

  O20040220001157

  Same enrollment
• Physician Groups LC

  • Rural Health Clinic/Center
  • Centralia, MO
  • NPI 1164615316

  O20040220001157

  Same enrollment
• Physician Groups LC

  • Primary Care Clinic/Center
  • Florissant, MO
  • NPI 1174699243

  O20040220001157

  Same enrollment
• Physician Groups LC

  • Oncology Clinic/Center
  • Saint Peters, MO
  • NPI 1184791535

  O20040220001157

  Same enrollment

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

• Internal Medicine Specialists Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 26, 2008.

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206489600000",
    "number": "1043386147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 MASON RIDGE CENTER DR",
            "address_2": "SUITE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418573",
            "telephone_number": "314-996-7644",
            "fax_number": "314-996-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD",
            "address_2": "SUITE 315A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312322",
            "telephone_number": "314-996-5900",
            "fax_number": "314-996-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN GROUPS LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2008-03-26",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-286-2028",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILRAOD",
            "identifier": "CN1994",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Internal Medicine Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Physical and Sports Therapy Services of St Louis
• Physical Therapy Collective, LLC
• Physical Therapy Consultants, Inc
• Physical Therapy Specialists in Neurology and Orthopedics PC
• Physician Correctional USA (Mo.), LLC
• Physician Groups LC
• Physician Groups LC
• Physician Groups LC
• Physician Groups LC
• Physician Groups LC

• All providers in Saint Louis, MO
• Primary Care Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.