Active NPI
Gary Dean Powell
- Laboratory Management Specialist/Technologist
- Saint Peters, MO
National Provider Identifier
1083128326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Laboratory Management Specialist/Technologist
- Practice address
- 1207 Colby Dr
Saint Peters, MO 63376-5512 - Phone
- (314) 401-2531
- NPI assigned
- Nov 23, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Laboratory Management Specialist/Technologist | 246QL0900X | Primary |
Addresses
Primary practice location
1207 Colby Dr
Saint Peters, MO 63376-5512
Mailing address
1207 Colby Dr
Saint Peters, MO 63376-5512
Phone (314) 401-2531
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 919983040 | Other | MO | UNITED HEALTHCARE |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511395200000",
"number": "1083128326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1207 COLBY DR",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633765512",
"telephone_number": "314-401-2531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1207 COLBY DR",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633765512",
"telephone_number": "314-401-2531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POWELL",
"first_name": "GARY",
"middle_name": "DEAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-11-23",
"last_updated": "2017-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "246QL0900X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Pathology, Laboratory Management",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "919983040",
"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 Nov 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.