Individual provider Active NPI

Kathleen H Slocomb, MD

  • Pain Medicine (Anesthesiology) Physician
  • Belleville, IL
National Provider Identifier
1053418251
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Practice address
4500 Memorial Drive
Belleville, IL 62223
Phone
(618) 257-4076
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X IL Primary

Addresses

Primary practice location

4500 Memorial Drive
Belleville, IL 62223

Mailing address

940 West Port Plaza
Ste 270
Saint Louis, MO 63146
Phone (314) 453-0600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036081855ILMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Anesthesia Providers S.C Pain Medicine CurrentSince Jan 10, 2023 Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

1404 Cross St
Shiloh, IL 62269
Phone (618) 607-1000

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053418251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 WEST PORT PLAZA",
            "address_2": "STE 270",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63146",
            "telephone_number": "314-453-0600",
            "fax_number": "314-453-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DRIVE",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62223",
            "telephone_number": "618-257-4076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOCOMB",
        "first_name": "KATHLEEN",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.