NPIMap

Individual provider Active NPI

Carl E. Bussmann, M,D.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Saint Louis, MO
National Provider Identifier
1053303636
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
R7913 Issued in MO
Practice address
11133 Dunn Rd
Department of EMS
Saint Louis, MO 63136-6119
Phone
(314) 653-5663
Fax
(314) 653-4164
NPI assigned
Aug 18, 2005
Last updated
Jun 26, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X R7913 MO
Emergency Medicine Physician 207P00000X 036117250 IL
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X R7913 MO Primary
Trauma Surgery Physician 2086S0127X R7913 MO
Vascular Surgery Physician 2086S0129X R7913 MO

Addresses

Primary practice location

11133 Dunn Rd
Department of EMS
Saint Louis, MO 63136-6119

Mailing address

409 Conway Village Dr
Saint Louis, MO 63141-5803
Phone (314) 878-3571

Other identifiers 2

IdentifierTypeStateIssuer
201656410MedicaidMO
201656410MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R7913MOMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yates Emergency Physicians Emergency Medicine Past Accepting new patients
North County Emergency Physicians, LLP Emergency Medicine Past Accepting new patients
Emcare Physician Providers, Inc. Emergency Medicine Past Accepting new patients
Kennett Emergency Physicians Emergency Medicine Past Accepting new patients
Missouri Em-I Medical Services, PC Past Accepting new patients
Missouri Em-I Medical Services, P.C. Past Accepting new patients
St Alexius Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214438400000",
    "number": "1053303636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 CONWAY VILLAGE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415803",
            "telephone_number": "314-878-3571",
            "fax_number": "314-439-9593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11133 DUNN RD",
            "address_2": "DEPARTMENT OF EMS",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366119",
            "telephone_number": "314-653-5663",
            "fax_number": "314-653-4164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSSMANN",
        "first_name": "CARL",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M,D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2008-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "R7913",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036117250",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MO",
            "license": "R7913",
            "primary": true
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "MO",
            "license": "R7913",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MO",
            "license": "R7913",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201656410",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201656410",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.