NPIMap

Organization Active NPI

John P Marino MD LLC

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1124359237
Registry record updated Jan 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R2C27 Issued in MO
Legal business name
JOHN P MARINO MD LLC
Practice address
6651 Chippewa St
Suite 301
Saint Louis, MO 63109-2538
Phone
(314) 842-5670
Fax
(314) 842-2889
NPI assigned
Jan 29, 2010
Last updated
Jan 29, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2010

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

Authorized official

Name
Dr. John P Marino, MDNPI 1922112523
Title
Owner
Phone
(314) 842-5670

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X R2C27 MO Primary

Addresses

Primary practice location

6651 Chippewa St
Suite 301
Saint Louis, MO 63109-2538

Mailing address

6651 Chippewa St
Suite 301
Saint Louis, MO 63109-2538
Phone (314) 842-5670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100526000007 MO Part B Supplier - Clinic/Group Practice 2365571692 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Louis, MO

National Provider Directory

National Provider Directory

Locations

10004 Kennerly Rd
Ste 185B
Saint Louis, MO 63128
Phone (314) 842-5670

6651 Chippewa St
Ste 301
Saint Louis, MO 63109
Phone (314) 644-6414

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1264723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264723200000",
    "number": "1124359237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6651 CHIPPEWA ST",
            "address_2": "SUITE 301",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631092538",
            "telephone_number": "314-842-5670",
            "fax_number": "314-842-2889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6651 CHIPPEWA ST",
            "address_2": "SUITE 301",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631092538",
            "telephone_number": "314-842-5670",
            "fax_number": "314-842-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN P MARINO MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-29",
        "last_updated": "2010-01-29",
        "status": "A",
        "authorized_official_last_name": "MARINO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-842-5670",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R2C27",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Jan 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.