Individual provider Active NPI

John A Stith, MD

  • Pediatric Otolaryngology Physician
  • Saint Louis, MO
National Provider Identifier
1164449757
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
R1K77 Issued in MO
Practice address
3660 Vista
St Louis, MO 63110
Phone
(314) 577-8887
Fax
(314) 268-5111
NPI assigned
Jul 17, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X R1K77 MO
Pediatric Otolaryngology Physician 207YP0228X R1K77 MO Primary

Addresses

Primary practice location

3660 Vista
St Louis, MO 63110

Mailing address

3691 Rutger Ave
Provider Enrollment
St Louis, MO 63110
Phone (314) 977-3828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090305000176 MO Practitioner - OtolaryngologyPractitioner - Pediatric Medicine 2264598903 Reassigns benefits to 1 organization
I20220721002972 IL Practitioner - Otolaryngology 2264598903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Pediatric Medicine
Education
Ohio State University College of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Patheous Medical PLLCGroup PAC ID 8921458720, 18 clinicians

Practice addresses (Care Compare)

11618 Gravois Rd
Saint Louis, MO 63126-3014
Phone (913) 359-6021

453 S Vermont St
Suite C
Palatine, IL 60067-6968
Phone (913) 359-6021

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Patheous Medical PLLC CurrentSince Dec 20, 2023 Accepting new patients

Locations

453 S Vermont St
Ste C
Palatine, IL 60067
Phone (913) 359-6001

10551 Barkley St
Ste 400
Overland Park, KS 66212

11618 Gravois Rd
Saint Louis, MO 63126
Phone (314) 239-9740

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1164449757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3691 RUTGER AVE",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63110",
            "telephone_number": "314-977-3828",
            "fax_number": "314-977-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 VISTA",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63110",
            "telephone_number": "314-577-8887",
            "fax_number": "314-268-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STITH",
        "first_name": "JOHN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MO",
            "license": "R1K77",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "MO",
            "license": "R1K77",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.