Organization Active NPI

Jianmei Liu, MD, LLC

  • Internal Medicine Physician
  • St Louis, MO
National Provider Identifier
1053528646
Registry record updated Jan 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2004024409 Issued in MO
Legal business name
JIANMEI LIU, MD, LLC
Practice address
6400 Clayton Ave
Suite 401
St Louis, MO 63117
Phone
(314) 644-6500
Fax
(314) 644-6501
NPI assigned
May 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2015

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

Authorized official

Name
Dr. Jianmei Liu, M.D.NPI 1114949963
Title
President
Phone
(314) 644-6400

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: 193400000X SINGLE SPECIALTY GROUP 207R00000X 2004024409 MO Primary

Addresses

Primary practice location

6400 Clayton Ave
Suite 401
St Louis, MO 63117

Mailing address

6400 Clayton Ave
Suite 401
St Louis, MO 63117
Phone (314) 644-6500

Other identifiers 1

IdentifierTypeStateIssuer
507011500MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070605000056 MO Part B Supplier - Clinic/Group Practice 2365540002 Receives reassigned benefits from 1 practitioner
Practice locations: Creve Coeur, MO; St Louis, MO; Florissant, MO; Chesterfield, MO; Chesterfeild, MT

National Provider Directory

National Provider Directory

Locations

6400 Clayton Rd
Ste 401
Saint Louis, MO 63117
Phone (314) 644-6500

Practitioners & affiliated clinicians

Practitioners 1

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": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421539200000",
    "number": "1053528646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 CLAYTON AVE",
            "address_2": "SUITE 401",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63117",
            "telephone_number": "314-644-6500",
            "fax_number": "314-644-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 CLAYTON AVE",
            "address_2": "SUITE 401",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63117",
            "telephone_number": "314-644-6500",
            "fax_number": "314-644-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIANMEI LIU, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2015-01-18",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "JIANMEI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-644-6400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2004024409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "507011500",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2015; 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.