Individual provider Active NPI

Jad Antoine Khoury, M.D.

  • Infectious Disease Physician
  • Saint Louis, MO
National Provider Identifier
1144250028
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
2003015237 Issued in MO
Practice address
621 S New Ballas Rd # 7018
Saint Louis, MO 63141-8232
Phone
(314) 251-4949
Fax
(314) 251-4368
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 2003015237 MO Primary

Addresses

Primary practice location

621 S New Ballas Rd # 7018
Saint Louis, MO 63141-8232

Mailing address

621 S New Ballas Rd Ste 7018
Saint Louis, MO 63141-8232
Phone (314) 251-4949

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060110001152 MO Practitioner - Infectious Disease 9537182092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Infectious Disease LLCGroup PAC ID 6103058862, 4 clinicians

Practice addresses (Care Compare)

621 S New Ballas Rd
Suite 7018B
Saint Louis, MO 63141-8256
Phone (314) 251-4949

Hospital & facility affiliations

  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2003015237MOMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Infectious Disease LLC Infectious Disease CurrentSince Dec 14, 2013 Accepting new patients
Infectious Disease Consultants, Inc. Infectious Disease PastSince Aug 1, 1993 Accepting new patients

Locations

621 S New Ballas Rd
Ste 7018B
Saint Louis, MO 63141
Phone (314) 251-4949

Interoperability endpoints

  • Direct secure messaging: jkhoury100142@directc.mercy.net

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383523200000",
    "number": "1144250028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 7018",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-4949",
            "fax_number": "314-251-4368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD # 7018",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-4949",
            "fax_number": "314-251-4368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOURY",
        "first_name": "JAD",
        "middle_name": "ANTOINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2013-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MO",
            "license": "2003015237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.