Active NPI
Jerrold J Lander, M.D.
- Gastroenterology Physician
- Chesterfield, MO
National Provider Identifier
1063527984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 31787
- Practice address
- 222 S Woods Mill Rd
Suite 750
Chesterfield, MO 63017-3625 - Phone
- (314) 205-6600
- Fax
- (314) 434-5939
- NPI assigned
- Aug 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 31787 | MO | Primary |
Addresses
Primary practice location
222 S Woods Mill Rd
Suite 750
Chesterfield, MO 63017-3625
Mailing address
222 S Woods Mill Rd
Suite 750
Chesterfield, MO 63017-3625
Phone (314) 205-6600
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200591204 | Medicaid | MO | |
| 841682728 | Other | TAX ID | |
| P00255776 | Other | RR MEDICARE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 31787 | MO | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cardiothoracic Surgery, LLC | Past | Accepting new patients |
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.
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Chesterfield, MO
- NPI 1104895812
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438819200000",
"number": "1063527984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 S WOODS MILL RD",
"address_2": "SUITE 750",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "630173625",
"telephone_number": "314-205-6600",
"fax_number": "314-434-5939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 S WOODS MILL RD",
"address_2": "SUITE 750",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "630173625",
"telephone_number": "314-205-6600",
"fax_number": "314-434-5939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDER",
"first_name": "JERROLD",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-20",
"last_updated": "2015-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "MO",
"license": "31787",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200591204",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "841682728",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00255776",
"state": null
}
],
"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 Aug 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.