NPIMap

Organization Active NPI

Practice Management Affiliates Consulting Inc

  • Family Medicine Physician
  • Saint Peters, MO
National Provider Identifier
1053341289
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PRACTICE MANAGEMENT AFFILIATES CONSULTING INC
Practice address
1600 Heritage LNDG
Suite 215
Saint Peters, MO 63303-8489
Phone
(636) 939-4200
Fax
(636) 939-4204
NPI assigned
Jul 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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

Authorized official

Name
Deborah Hall
Title
Administrator
Phone
(636) 939-4200

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X

Addresses

Primary practice location

1600 Heritage LNDG
Suite 215
Saint Peters, MO 63303-8489

Mailing address

1600 Heritage LNDG
Suite 215
Saint Peters, MO 63303-8489
Phone (636) 939-4200

Other practice location 1

3533 Dunn Rd Ste 204
Florissant, MO 63033-6761
Phone (314) 831-2600

Other identifiers 1

IdentifierTypeStateIssuer
505843003MedicaidMO

National Provider Directory

National Provider Directory

Locations

2137 Charbonier Rd
Florissant, MO 63031
Phone (314) 831-5999

300 Lake Saint Louis Blvd
Lake St Louis, MO 63367
Phone (636) 625-1211

2730 S Saint Peters Pkwy
Ste 202
Saint Peters, MO 63303
Phone (636) 939-4200

1600 Heritage Lndg
Ste 215
Saint Peters, MO 63303
Phone (636) 939-4200

Practitioners & affiliated clinicians

Practitioners 11

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": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583366400000",
    "number": "1053341289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 HERITAGE LNDG",
            "address_2": "SUITE 215",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633038489",
            "telephone_number": "636-939-4200",
            "fax_number": "636-939-4204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 HERITAGE LNDG",
            "address_2": "SUITE 215",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633038489",
            "telephone_number": "636-939-4200",
            "fax_number": "636-939-4204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3533 Dunn Rd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Florissant",
            "state": "MO",
            "postal_code": "630336761",
            "country_code": "US",
            "telephone_number": "314-831-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRACTICE MANAGEMENT AFFILIATES CONSULTING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "636-939-4200"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "505843003",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; 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.