NPIMap

Individual provider Active NPI

Bradley L Schlaggar, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Saint Louis, MO
National Provider Identifier
1144247685
Registry record updated Jan 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
110714 Issued in MO
Practice address
4921 Parkview PL Ste 6C
Ste 6C
Saint Louis, MO 63110-1032
Phone
(314) 362-6908
Fax
(314) 747-3258
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 110714 MO Primary

Addresses

Primary practice location

4921 Parkview PL Ste 6C
Ste 6C
Saint Louis, MO 63110-1032

Mailing address

660 S Euclid Ave
C B 8111
Saint Louis, MO 63110-1010
Phone (314) 362-6908

Other identifiers 2

IdentifierTypeStateIssuer
204632202MedicaidMO
ENROLLEDMedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, MD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070828000865 MO Practitioner - Neurology 3274625710 Reassigns benefits to 1 organization
I20191218000587 MD Practitioner - Neurology 3274625710 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Krieger Associates CurrentSince Oct 26, 2019 Accepting new patients
Kennedy Krieger Associates CurrentSince Oct 26, 2019 Accepting new patients
Washington University CurrentSince Aug 6, 2012 Accepting new patients
Washington University CurrentSince Aug 6, 2012 Accepting new patients

Locations

707 N Broadway
Baltimore, MD 21205
Phone (443) 923-1870

1741 Ashland Ave
Rm 642D
Baltimore, MD 21205

1 Childrens Pl
Saint Louis, MO 63110
Phone (314) 454-2076

4921 Parkview Pl
Ste 6C
Saint Louis, MO 63110
Phone (314) 362-6981

660 S Euclid Ave
#8111
Saint Louis, MO 63110
Phone (314) 362-3281

4455 Duncan Ave
Saint Louis, MO 63110
Phone (314) 658-3800

660 S Euclid Ave
#C
Saint Louis, MO 63110

Interoperability endpoints

  • Direct secure messaging: bschlaggar10181@direct.kennedykrieger.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kennedy Krieger InstituteBaltimore, MD, CCN 213301 Hospital Corporate Officer (100%) Aug 1, 2018

Owned or controlled facilities with NPI records 14

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 14

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517184000000",
    "number": "1144247685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "C B 8111",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-362-6908",
            "fax_number": "314-747-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 PARKVIEW PL STE 6C",
            "address_2": "STE 6C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101032",
            "telephone_number": "314-362-6908",
            "fax_number": "314-747-3258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLAGGAR",
        "first_name": "BRADLEY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2018-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "MO",
            "license": "110714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204632202",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.