JMJ Medical Enterprise, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

R5P40 Issued in MO

Legal business name

JMJ MEDICAL ENTERPRISE, LLC

Practice address

8790 Watson Rd Ste 201
Saint Louis, MO 63119-5140

Phone

(314) 774-0300

Fax

(844) 600-1085

NPI assigned

Jun 20, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Noel Casino

Title

Practice Administrator

Phone

(314) 283-8950

Specialties & licenses 2

Addresses

Other names 1

• JMJ Medical Doing business as

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573603200000",
    "number": "1093235129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8790 WATSON RD STE 201",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631195140",
            "telephone_number": "314-774-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8790 WATSON RD STE 201",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631195140",
            "telephone_number": "314-774-0300",
            "fax_number": "844-600-1085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JMJ MEDICAL ENTERPRISE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-20",
        "last_updated": "2019-11-13",
        "status": "A",
        "authorized_official_last_name": "CASINO",
        "authorized_official_first_name": "NOEL",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "314-283-8950",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "R5P40",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "MO",
            "license": "R5P40",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JMJ Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatrics Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; 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.