Active NPI
Alice Kelubia Azzun, MD
- Obstetrics & Gynecology Physician
- Saint Louis, MO
National Provider Identifier
1104393107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 2026024990
- Practice address
- 1 Barnes Jew Hosp PLZ
Saint Louis, MO 63110-1003 - Phone
- (314) 363-1717
- NPI assigned
- Oct 28, 2018
- Last updated
- Jun 5, 2026
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 2026024990 | MO | Primary |
Addresses
Primary practice location
1 Barnes Jew Hosp PLZ
Saint Louis, MO 63110-1003
Mailing address
1 Barnes Jew Hosp PLZ
Saint Louis, MO 63110-1003
Other names 1
- Dr. Alice Kelubia Azzun
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260616003660 | MO | Order and Referring Only - Obstetrics/Gynecology | 9830661263 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2026024990 | MO | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780617600000",
"number": "1104393107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 BARNES JEW HOSP PLZ",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BARNES JEW HOSP PLZ",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101003",
"telephone_number": "314-363-1717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AZZUN",
"first_name": "ALICE",
"middle_name": "KELUBIA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-28",
"last_updated": "2026-06-05",
"certification_date": "2026-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "MO",
"license": "2026024990",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ALICE",
"last_name": "AZZUN",
"middle_name": "KELUBIA",
"prefix": "DR.",
"credential": "MD",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.