St Gabriel Clinic CDM

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ST GABRIEL CLINIC CDM

Practice address

6115 Ridge Ave
Saint Louis, MO 63133-2616

Phone

(314) 230-9050

Fax

(844) 870-7109

NPI assigned

Nov 10, 2023

Last updated

Nov 10, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Daniel Desta Bekele, MDNPI 1447762919

Title

Owner

Phone

(720) 235-6443

Specialties & licenses 1

Addresses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18172/brand/1/csg/1/fhir/r4

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.

• Daniel Desta Bekele, MD

  • General Practice Physician
  • Saint Louis, MO
  • NPI 1447762919
  Authorized official Same address or phone

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

{
    "created_epoch": "1699574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699574400000",
    "number": "1144094087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6115 RIDGE AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631332616",
            "telephone_number": "314-230-9050",
            "fax_number": "844-870-7109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6115 RIDGE AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631332616",
            "telephone_number": "314-230-9050",
            "fax_number": "844-870-7109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST GABRIEL CLINIC CDM",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-10",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A",
        "authorized_official_last_name": "BEKELE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "DESTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-235-6443",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2023; 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.