Active NPI
Tarik Kavazovic
- Prevention Professional
- Saint Louis, MO
National Provider Identifier
1154853513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prevention Professional
- License
- 2016037429
- Practice address
- 5204 Sir Bors Dr Apt 3
Saint Louis, MO 63129-1448 - Phone
- (314) 203-7637
- NPI assigned
- Apr 3, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prevention Professional | 405300000X | 2016037429 | MO | Primary |
Addresses
Primary practice location
5204 Sir Bors Dr Apt 3
Saint Louis, MO 63129-1448
Mailing address
5204 Sir Bors Dr Apt 3
Saint Louis, MO 63129-1448
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2016037429 | MO | MD | Prevention Professional |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491177600000",
"number": "1154853513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5204 SIR BORS DR APT 3",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631291448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5204 SIR BORS DR APT 3",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631291448",
"telephone_number": "314-203-7637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAVAZOVIC",
"first_name": "TARIK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-03",
"last_updated": "2017-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "MO",
"license": "2016037429",
"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 Apr 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.