St Vincent Medical Center

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

Legal business name

ST VINCENT MEDICAL CENTER

Practice address

2131 West Third St
Los Angeles, CA 90057-0992

Phone

(213) 484-7111

NPI assigned

Apr 15, 2008

Reactivated

Apr 3, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Robert Jacoby

Title

Compliance Manager

Phone

(213) 484-7067

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491177600000",
    "number": "1184898736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2131 WEST THIRD ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900570992",
            "telephone_number": "213-484-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 WEST THIRD ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900570992",
            "telephone_number": "213-484-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST VINCENT MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2017-04-03",
        "deactivation_date": "2014-08-04",
        "reactivation_date": "2017-04-03",
        "status": "A",
        "authorized_official_last_name": "JACOBY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "COMPLIANCE MANAGER",
        "authorized_official_telephone_number": "213-484-7067",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSC30502H",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT40502H",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC5437G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeromiah St Louis
• St Nicholas Medical Group
• St Nicholas Medical Group
• Kimberly St Romain
• St Vincent Medical Center
• St Vincent Preventative Family Care
• St Vincent Radiological Medical Group
• St Vincent Radiological Medical Group, Inc
• St Vincent Senior Citizen Nutrition Program (St Vincent Meals on Wheels)
• St. Anne Medical Clinic Professional Corp

• General Acute Care Hospital in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Acute Care Hospital in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2017; 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.