Individual provider Active NPI

Richard Denis Haslam, MB, BCH, BAO

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1174418875
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2025021641 Issued in MO
Practice address
4921 Parkview PL
Saint Louis, MO 63110-1032
Phone
(314) 362-7578
NPI assigned
Jun 11, 2025
Last updated
Jun 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2025021641 MO Primary

Addresses

Primary practice location

4921 Parkview PL
Saint Louis, MO 63110-1032

Mailing address

4615 Lindell Blvd Apt 705
Saint Louis, MO 63108-3719
Phone (610) 453-5395

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
I20250619000927 MO Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9335650977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2025021641MOMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1749600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1174418875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4615 LINDELL BLVD APT 705",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631083719",
            "telephone_number": "610-453-5395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 PARKVIEW PL",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101032",
            "telephone_number": "314-362-7578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASLAM",
        "first_name": "RICHARD",
        "middle_name": "DENIS",
        "credential": "MB, BCH, BAO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-11",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2025021641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.