Organization Active NPI

Bimla Dhan LLC

  • Internal Medicine Physician
  • Bridgeton, MO
National Provider Identifier
1043457906
Registry record updated Sep 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2008010948 Issued in MO
Legal business name
BIMLA DHAN LLC
Practice address
3394 McKelvey Rd Ste 115
Bridgeton, MO 63044-2531
Phone
(314) 643-7692
NPI assigned
Jan 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2018

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

Authorized official

Name
Anoj Goel, MDNPI 1669446498
Title
Owner
Phone
(314) 518-3382

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 2008010948 MO Primary

Addresses

Primary practice location

3394 McKelvey Rd Ste 115
Bridgeton, MO 63044-2531

Mailing address

15 Terry Hill LN
Saint Louis, MO 63131-2422
Phone (314) 518-3382

Other practice location 1

3535 S Jefferson Ave Ste 2
Saint Louis, MO 63118-3930
Phone (314) 669-7070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090513000129 MO Part B Supplier - Clinic/Group Practice 1254480700 Receives reassigned benefits from 4 practitioners
Practice locations: Bridgeton, MO

National Provider Directory

National Provider Directory

Locations

998 Woods Mill Rd
Ballwin, MO 63011
Phone (314) 658-3800

3535 S Jefferson Ave
Ste 201
Saint Louis, MO 63118
Phone (314) 567-2061

Practitioners & affiliated clinicians

Practitioners 4

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": "1231891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536969600000",
    "number": "1043457906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 TERRY HILL LN",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312422",
            "telephone_number": "314-518-3382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3394 MCKELVEY RD STE 115",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442531",
            "telephone_number": "314-643-7692"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 S Jefferson Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631183930",
            "country_code": "US",
            "telephone_number": "314-669-7070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BIMLA DHAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-14",
        "last_updated": "2018-09-15",
        "status": "A",
        "authorized_official_last_name": "GOEL",
        "authorized_official_first_name": "ANOJ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-518-3382",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2008010948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2018; 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.