Organization Active NPI

Kids Docs PC

  • Pediatrics Physician
  • St. Louis, MO
National Provider Identifier
1174781397
Registry record updated May 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
KIDS DOCS PC
Practice address
12401 Olive Blvd
Ste 204
St. Louis, MO 63141
Phone
(314) 469-2100
Fax
(314) 469-2981
NPI assigned
May 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2008

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

Authorized official

Name
Albina Mujakovic
Title
Office Manager
Phone
(314) 469-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

12401 Olive Blvd
Ste 204
St. Louis, MO 63141

Mailing address

12401 Olive Blvd
Ste 204
St. Louis, MO 63141
Phone (314) 469-2100

National Provider Directory

National Provider Directory

Locations

12401 Olive Blvd
Ste 204
Saint Louis, MO 63141
Phone (314) 469-2100

NPI Registry JSON

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

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211500800000",
    "number": "1174781397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12401 OLIVE BLVD",
            "address_2": "STE 204",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-469-2100",
            "fax_number": "314-469-2981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12401 OLIVE BLVD",
            "address_2": "STE 204",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-469-2100",
            "fax_number": "314-469-2981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS DOCS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-23",
        "last_updated": "2008-05-23",
        "status": "A",
        "authorized_official_last_name": "MUJAKOVIC",
        "authorized_official_first_name": "ALBINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "314-469-2100"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; 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.