Individual provider Active NPI

Richard Glenn Brandel, D.P.M.

  • Podiatrist
  • Saint Louis, MO
National Provider Identifier
1154323657
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
000482 Issued in MO
Practice address
950 Francis PL
Suite 2
Saint Louis, MO 63105-2465
Phone
(314) 726-2377
Fax
(314) 726-2397
NPI assigned
Aug 15, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 000482 MO Primary

Addresses

Primary practice location

950 Francis PL
Suite 2
Saint Louis, MO 63105-2465

Mailing address

950 Francis PL
Suite 2
Saint Louis, MO 63105-2465
Phone (314) 726-2377

Other identifiers 1

IdentifierTypeStateIssuer
301731907MedicaidMO

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

State licenses

LicenseStateTypeSpecialty
000482MOMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical West Podiatry LTD Medical West BLDG Podiatrist CurrentSince Jun 1, 1998 Accepting new patients

Locations

950 Francis Pl
Ste 2
Saint Louis, MO 63105
Phone (314) 726-2377

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154323657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 FRANCIS PL",
            "address_2": "SUITE 2",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631052465",
            "telephone_number": "314-726-2377",
            "fax_number": "314-726-2397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 FRANCIS PL",
            "address_2": "SUITE 2",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631052465",
            "telephone_number": "314-726-2377",
            "fax_number": "314-726-2397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDEL",
        "first_name": "RICHARD",
        "middle_name": "GLENN",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MO",
            "license": "000482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "301731907",
            "state": "MO"
        }
    ],
    "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 Jul 8, 2007; 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.