Active NPI
Kenneth Bryan Trimmer, D.O.
- Interventional Cardiology Physician
- Saint Louis, MO
National Provider Identifier
1124060975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Cardiology Physician
- License
- R8D06
- Practice address
- 3023 N Ballas Rd Ste 200D
Saint Louis, MO 63131-2328 - Phone
- (314) 996-7272
- NPI assigned
- Jun 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | R8D06 | MO | |
| Interventional Cardiology Physician | 207RI0011X | R8D06 | MO | Primary |
Addresses
Primary practice location
3023 N Ballas Rd Ste 200D
Saint Louis, MO 63131-2328
Mailing address
3023 N Ballas Rd Ste 200D
Saint Louis, MO 63131-2328
Phone (314) 996-7272
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 242012102 | Medicaid | MO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2 | Health Information Exchange (HIE) |
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 Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Barnes Jewish St. Peters Hospital Inc. | Current | Accepting new patients | |
| Cardiology Diagnostics, LTD. | Cardiovascular Disease | Past | Accepting new patients |
| Ozarks Medical Center | Past | Accepting new patients | |
| Cardiology Diagnostics, LTD. | Cardiovascular Disease | Past | Accepting new patients |
Locations
10 Hospital Dr
Saint Peters, MO 63376
Phone (636) 394-2522
Interoperability endpoints
- ktrimmer11256@direct.carenet.org
- https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Organizations & group practices 4
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.
-
- General Practice Physician
- Saint Peters, MO
- NPI 1235148271
-
- Cardiovascular Disease Physician
- Saint Louis, MO
- NPI 1194778761
-
- Cardiovascular Disease Physician
- Farmington, MO
- NPI 1417128372
-
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621382400000",
"number": "1124060975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3023 N BALLAS RD STE 200D",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631312328",
"telephone_number": "314-996-7272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3023 N BALLAS RD STE 200D",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631312328",
"telephone_number": "314-996-7272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRIMMER",
"first_name": "KENNETH",
"middle_name": "BRYAN",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2021-05-19",
"certification_date": "2021-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "MO",
"license": "R8D06",
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "MO",
"license": "R8D06",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "242012102",
"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": "3023 N Ballas Rd",
"address_2": "Suite 200D",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631312330",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
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 May 19, 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.