Pitt Vesom, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

2003026274 Issued in MO

Practice address

1149 Hickory Ridge TRL
Arnold, MO 63010-2760

Phone

(636) 282-1918

Fax

(636) 282-1918

NPI assigned

May 24, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Pittaya Vejviboonsom Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Kennett Hma Physician Management, LLC

  • Internal Medicine Physician
  • Kennett, MO
  • NPI 1245445196

  Cardiovascular Disease

  NPD (past)

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1073568150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1149 HICKORY RIDGE TRL",
            "city": "ARNOLD",
            "state": "MO",
            "postal_code": "630102760",
            "telephone_number": "636-282-1918",
            "fax_number": "636-282-1918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1149 HICKORY RIDGE TRL",
            "city": "ARNOLD",
            "state": "MO",
            "postal_code": "630102760",
            "telephone_number": "636-282-1918",
            "fax_number": "636-282-1918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VESOM",
        "first_name": "PITT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2003026274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202104105",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PITTAYA",
            "last_name": "VEJVIBOONSOM",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David Anthony Vandeven, MS RDN LD
• Abigail Dawn Vanvacter
• Sneha Miriam Varghese, PHARM.D.
• Chelsea A Vasel, D.C.
• Marsha Vedova, M.D.
• Molly Vessell, PLPC
• Ashley Nicole Veteto
• Cheryl Viau, APRN, FNP-BC, NP-C
• Visionworks, Inc (Visionworks)
• Megan Vogl, SLP-CF

• Cardiovascular Disease Physician in Arnold, MO
• Providers in Arnold, MO by specialty
• Cardiovascular Disease Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.