Individual provider Active NPI

Kenneth Bryan Trimmer, D.O.

  • Interventional Cardiology Physician
  • Saint Louis, MO
National Provider Identifier
1124060975
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
R8D06 Issued in MO
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

Updated by the provider on May 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
242012102MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
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

OrganizationSpecialtyStatusNew 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

  • Direct secure messaging: ktrimmer11256@direct.carenet.org
  • FHIR API: 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.

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.

Verify at the official NPI Registry.