Active NPI
Specialty & Primary Care LLC
- Gastroenterology Physician
- Saint Louis, MO
National Provider Identifier
1104954692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 109425
- Legal business name
- SPECIALTY & PRIMARY CARE LLC
- Practice address
- 3009 N Ballas Rd
Suite 229a
Saint Louis, MO 63131-2322 - Phone
- (314) 432-5144
- Fax
- (314) 432-2400
- NPI assigned
- Feb 28, 2007
- Last updated
- Mar 17, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Nayyer Ibrahim
- Title
- Administrator
- Phone
- (314) 432-5144
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 109425 | MO | Primary |
Addresses
Primary practice location
3009 N Ballas Rd
Suite 229a
Saint Louis, MO 63131-2322
Mailing address
3009 N Ballas Rd
Suite 229a
Saint Louis, MO 63131-2322
Phone (314) 432-5144
National Provider Directory
National Provider DirectoryLocations
3009 N Ballas Rd
Ste 229A
Saint Louis, MO 63131
Phone (314) 432-5144
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Gastroenterology Physician
- Springfield, IL
- NPI 1124013636
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1237248000000",
"number": "1104954692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3009 N BALLAS RD",
"address_2": "SUITE 229A",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631312322",
"telephone_number": "314-432-5144",
"fax_number": "314-432-2400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3009 N BALLAS RD",
"address_2": "SUITE 229A",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631312322",
"telephone_number": "314-432-5144",
"fax_number": "314-432-2400"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SPECIALTY & PRIMARY CARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-28",
"last_updated": "2009-03-17",
"status": "A",
"authorized_official_last_name": "IBRAHIM",
"authorized_official_first_name": "NAYYER",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "314-432-5144"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": "MO",
"license": "109425",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
- Specialists in Anesthesia PC
- Specialists in OB-GYN, Inc
- Specialists in Oncology & Hematology, P.C.
- Specialized Imaging Services, Inc. (Diagnostic Health Services)
- Specialized Physical Therapy LLC
- Specialty and Primary Care LLC
- Specialty Healthcare Systems, LLC
- Specialty Retail Pharmacy
- Randall C Speck, M.D.
- Kathy Jane Speckart, COTA L
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.