Individual provider Active NPI

Amy C Rauchway, D.O.

  • Neurology Physician
  • Chesterfield, MO
National Provider Identifier
1053336859
Registry record updated Dec 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
2005011420 Issued in MO
Practice address
1176 Town and Country Commons
Chesterfield, MO 63017-8200
Phone
(636) 893-1260
Fax
(636) 893-1261
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 2005011420 MO Primary

Addresses

Primary practice location

1176 Town and Country Commons
Chesterfield, MO 63017-8200

Mailing address

1176 Town & Country Commons
Chesterfield, MO 63017
Phone (636) 893-1260

Other identifiers 2

IdentifierTypeStateIssuer
P00987639OtherMORAILROAD MEDICARE
1053336859MedicaidMO

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
2005011420MOMDNeurology Physician

Interoperability endpoints

  • Direct secure messaging: arauchway214071@directc.mercy.net

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417651200000",
    "number": "1053336859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1176 TOWN & COUNTRY COMMONS",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "63017",
            "telephone_number": "636-893-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1176 TOWN AND COUNTRY COMMONS",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630178200",
            "telephone_number": "636-893-1260",
            "fax_number": "636-893-1261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAUCHWAY",
        "first_name": "AMY",
        "middle_name": "C",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2014-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "2005011420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00987639",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053336859",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; 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.