NPIMap

Organization Active NPI

Dillon Plaza Family Medicine Group LC

  • Family Medicine Physician
  • High Ridge, MO
National Provider Identifier
1194055434
Registry record updated Feb 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DILLON PLAZA FAMILY MEDICINE GROUP LC
Practice address
1 Dillon Plaza Dr
High Ridge, MO 63049-2478
Phone
(636) 677-3012
NPI assigned
Jan 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2014

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

Authorized official

Name
Marylynne Pope
Title
Owner
Phone
(636) 677-3174

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1 Dillon Plaza Dr
High Ridge, MO 63049-2478

Mailing address

1 Dillon Plaza Dr
High Ridge, MO 63049-2478
Phone (636) 677-3012

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1262995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392854400000",
    "number": "1194055434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DILLON PLAZA DR",
            "city": "HIGH RIDGE",
            "state": "MO",
            "postal_code": "630492478",
            "telephone_number": "636-677-3012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DILLON PLAZA DR",
            "city": "HIGH RIDGE",
            "state": "MO",
            "postal_code": "630492478",
            "telephone_number": "636-677-3012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DILLON PLAZA FAMILY MEDICINE GROUP LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-09",
        "last_updated": "2014-02-20",
        "status": "A",
        "authorized_official_last_name": "POPE",
        "authorized_official_first_name": "MARYLYNNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-677-3174"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Ridge, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; 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.