John J. O'Brien, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R3E76 Issued in MO

Practice address

2630 Highway K
O Fallon, MO 63368-6624

Phone

(636) 240-5454

Fax

(618) 980-5335

NPI assigned

Feb 22, 2006

Last updated

Feb 24, 2021By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jobrien1196@directc.mercy.net

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.

• American Multispecialty Group Inc.

  dba Esse Health

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1972559532

  Family Medicine

  NPD

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1083689061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 HIGHWAY K",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633686624",
            "telephone_number": "636-240-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 HIGHWAY K",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633686624",
            "telephone_number": "636-240-5454",
            "fax_number": "618-980-5335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9426 Phoenix Village Pkwy",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "MO",
            "postal_code": "633684781",
            "country_code": "US",
            "telephone_number": "636-561-5999",
            "fax_number": "636-561-4746",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "JOHN",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R3E76",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080171320",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2630 Highway K",
            "city": "O Fallon",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633686624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Numpol Dejtiranukul DMD LLC
• Nursing Angels Home Care, LLC
• Nursing Angels, LLC
• Nystrom Counseling Mo, PC (Sagent Behavioral Health)
• Rachel O Brien, DC
• John J O'Connor, M.D.
• O'Fallon Dental Partnership, Barry Brace, DMD and Associates, LLC
• O'Fallon Dermatology Specialists, P.C.
• O'Fallon Family Dentistry
• O'Fallon Family Eye Care LLC (O'Fallon Family Eyecare)

• Family Medicine Physician in O'Fallon, MO
• Providers in O'Fallon, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; 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.