Kamal R Demetry, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

105483 Issued in MO

Practice address

4438 Telegraph Rd
Saint Louis, MO 63129-3316

Phone

(314) 742-6000

NPI assigned

Jul 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• BC Missouri Emergency Physicians, LLP

  • Emergency Medicine Physician
  • Saint Louis, MO
  • NPI 1003831678
  NPD (past)
• Mercy Clinic East Communities

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1851335228
  NPD (past)
• DRS Pichet & Meechai

  • Internal Medicine Physician
  • Red Bud, IL
  • NPI 1417058777
  NPD (past)
• Pamella S Gronemeyer

  • Clinical Medical Laboratory
  • Highland, IL
  • NPI 1194874966
  NPD (past)
• Red Bud Clinic Corp

  • Family Medicine Physician
  • Red Bud, IL
  • NPI 1083617609
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1174548549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4438 TELEGRAPH RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631293316",
            "telephone_number": "314-742-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4438 TELEGRAPH RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631293316",
            "telephone_number": "314-742-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12634 Olive Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631416337",
            "country_code": "US",
            "telephone_number": "314-434-0600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMETRY",
        "first_name": "KAMAL",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME83088",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "105483",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-094350",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "105483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4438 Telegraph Rd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631293316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bethany Lynn Dement, MD
• Amanda Demeo, M.D.
• Mildred Demeo, CRNA
• Lee Michael Demertzis, MD
• Angela Joann Demetrulias, OD
• Galina Demidenko, AGPCNP
• Tatyana R Demidovich, MD
• Rachel Stevens Deming, MD
• Melek Demirhan, MD
• Samantha Grace Demoor

• Internal Medicine Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.