Active NPI
John H Niemeyer, MD
- Diagnostic Radiology Physician
- St Louis, MO
National Provider Identifier
1083621155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- R4F79
- Practice address
- 3015 N New Ballas Rd
St Louis, MO 63131 - Phone
- (314) 996-5180
- Fax
- (314) 821-2180
- NPI assigned
- Aug 2, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | R4F79 | MO | Primary |
| Diagnostic Radiology Physician | 2085R0202X | 036108453 | IL |
Addresses
Primary practice location
3015 N New Ballas Rd
St Louis, MO 63131
Mailing address
55 Westport PLZ
Suite 300
Saint Louis, MO 63146-3109
Phone (314) 548-4772
Other identifiers 17
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003013128 | Other | CARE | |
| 398022 | Other | HLT PART | |
| 431725842MID | Other | MERCY | |
| 6707 | Other | HCARE USA | |
| 008012444 | Other | MO CARE | |
| 101033 | Other | H LINK | |
| 1078154 | Other | MC MCAID | |
| A12511 | Other | GATE WAY | |
| 300066988 | Other | RR CARE | |
| 003013128 | Other | MO CARE | |
| 008012444 | Other | CARE | |
| 1650514 | Other | PH PLAN | |
| 28081 | Other | BLUE CHOICE | |
| 2781 | Other | GHP | |
| 0090000352 | Other | IL BLUE | |
| 1390 | Other | MO BLUE | |
| 202282406 | Other | MO CAID |
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 |
|---|---|---|---|
| R4F79 | MO | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kirkwood Diagnostic & Orthopedic Associates, LLC. | Past | Accepting new patients | |
| Diagnostic Health Corporation | Past | Accepting new patients |
Interoperability endpoints
- jniemeyer154997@direct.carenet.org
- https://fhir4.healow.com/fhir/r4/DGEHCD
Organizations & group practices 2
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.
-
- Sports Medicine (Family Medicine) Physician
- Saint Louis, MO
- NPI 1295839702
-
- Physiological Laboratory
- Orange Park, FL
- NPI 1093764508
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237334400000",
"number": "1083621155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 WESTPORT PLZ",
"address_2": "SUITE 300",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631463109",
"telephone_number": "314-548-4772",
"fax_number": "314-548-4748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3015 N NEW BALLAS RD",
"city": "ST LOUIS",
"state": "MO",
"postal_code": "63131",
"telephone_number": "314-996-5180",
"fax_number": "314-821-2180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIEMEYER",
"first_name": "JOHN",
"middle_name": "H",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-02",
"last_updated": "2009-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MO",
"license": "R4F79",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IL",
"license": "036108453",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE",
"identifier": "003013128",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HLT PART",
"identifier": "398022",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MERCY",
"identifier": "431725842MID",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HCARE USA",
"identifier": "6707",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MO CARE",
"identifier": "008012444",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "H LINK",
"identifier": "101033",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MC MCAID",
"identifier": "1078154",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATE WAY",
"identifier": "A12511",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR CARE",
"identifier": "300066988",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MO CARE",
"identifier": "003013128",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE",
"identifier": "008012444",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PH PLAN",
"identifier": "1650514",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHOICE",
"identifier": "28081",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHP",
"identifier": "2781",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IL BLUE",
"identifier": "0090000352",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MO BLUE",
"identifier": "1390",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MO CAID",
"identifier": "202282406",
"state": null
}
],
"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 Mar 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.