Specialty and Primary Care LLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

109425 Issued in MO

Legal business name

SPECIALTY AND PRIMARY CARE LLC

Practice address

10004 Kennerly Rd
257 A
Saint Louis, MO 63128-2141

Phone

(314) 842-6333

Fax

(314) 543-5271

NPI assigned

Apr 24, 2007

Last updated

Oct 20, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Zafar Quader, MD

Title

Medical Director

Phone

(314) 842-6333

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shilpa M Agashe, MD

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1710066212
  NPD (past)
• Gonguntla V Naidu, MD

  • Gastroenterology Physician
  • Saint Louis, MO
  • NPI 1730130675
  NPD (past)
• Shahid Badar, M.D.

  • Internal Medicine Physician
  • Sugar Land, TX
  • NPI 1528113172
  NPD (past)

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445299200000",
    "number": "1174742720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD",
            "address_2": "257 A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282141",
            "telephone_number": "314-842-6333",
            "fax_number": "314-543-5271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD",
            "address_2": "257 A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282141",
            "telephone_number": "314-842-6333",
            "fax_number": "314-543-5271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY AND PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2015-10-20",
        "status": "A",
        "authorized_official_last_name": "QUADER",
        "authorized_official_first_name": "ZAFAR",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "314-842-6333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MO",
            "license": "109425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "361744184",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208721902",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA8910",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Gastroenterology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2015; 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.