Individual provider Active NPI

Joseph A. St. Louis Jr., M.D.

  • Ophthalmology Physician
  • Atlanta, GA
National Provider Identifier
1164429676
Registry record updated Dec 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
010675 Issued in GA
Practice address
5671 Peachtree Dunwoody Rd NE
Suite 400
Atlanta, GA 30342-5000
Phone
(404) 256-1507
Fax
(404) 256-1981
NPI assigned
Jun 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 010675 GA Primary

Addresses

Primary practice location

5671 Peachtree Dunwoody Rd NE
Suite 400
Atlanta, GA 30342-5000

Mailing address

5901 Peachtree Dunwoody Rd NE
Suite C-370
Atlanta, GA 30328-5382
Phone (678) 892-2020

Other identifiers 10

IdentifierTypeStateIssuer
589554OtherGABCBS
0808267OtherGAUHC
294532OtherGAWELLCARE
4266009OtherGAAETNA
501899OtherGAAETNA HMO
00062433BMedicaidGA
693018OtherGABCBS
00062433DMedicaidGA
03625OtherGACOVENTRY PPO
1407OtherGACOVENTRY HMO

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10677GAMDPharmacotherapy Pharmacist
010675GAMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197849600000",
    "number": "1164429676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE C-370",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285382",
            "telephone_number": "678-892-2020",
            "fax_number": "678-538-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5671 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 400",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303425000",
            "telephone_number": "404-256-1507",
            "fax_number": "404-256-1981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. LOUIS",
        "first_name": "JOSEPH",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2007-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "010675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "589554",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "0808267",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "294532",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4266009",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "501899",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00062433B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "693018",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00062433D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY PPO",
            "identifier": "03625",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY HMO",
            "identifier": "1407",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.