Individual provider Active NPI

John H Niemeyer, MD

  • Diagnostic Radiology Physician
  • St Louis, MO
National Provider Identifier
1083621155
Registry record updated Mar 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
R4F79 Issued in MO
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

Updated by the provider on Mar 18, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
003013128OtherCARE
398022OtherHLT PART
431725842MIDOtherMERCY
6707OtherHCARE USA
008012444OtherMO CARE
101033OtherH LINK
1078154OtherMC MCAID
A12511OtherGATE WAY
300066988OtherRR CARE
003013128OtherMO CARE
008012444OtherCARE
1650514OtherPH PLAN
28081OtherBLUE CHOICE
2781OtherGHP
0090000352OtherIL BLUE
1390OtherMO BLUE
202282406OtherMO 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

LicenseStateTypeSpecialty
R4F79MOMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kirkwood Diagnostic & Orthopedic Associates, LLC. Past Accepting new patients
Diagnostic Health Corporation PastSince Jan 1, 2004 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jniemeyer154997@direct.carenet.org
  • FHIR API: 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.

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.

Verify at the official NPI Registry.