John Michael Hatlelid, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

R8615 Issued in MO

Practice address

3009 N Ballas Rd Ste 102B
Saint Louis, MO 63131-2343

Phone

(314) 996-7080

NPI assigned

Feb 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Neurology Associates, Inc.

  • Specialist
  • Saint Louis, MO
  • NPI 1801883798

  Neurology

  NPD (past)

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1194796698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD STE 102B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312343",
            "telephone_number": "314-996-7080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 N BALLAS RD STE 102B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312343",
            "telephone_number": "314-996-7080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3009 N Ballas Rd",
            "address_2": "Suite 102B",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631312322",
            "country_code": "US",
            "telephone_number": "314-996-7080",
            "fax_number": "314-996-7085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HATLELID",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "R8615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "130001273",
            "state": "MO"
        }
    ],
    "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": "3009 N Ballas Rd Ste 102B",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessica Hatfield, LCPC
• Hatfill & Boothe Corp
• Taylor Jon Hathaway
• Carolyn Hathawayduchars, M.D.
• Vivian Mai Hathuc, D.O.
• Ralph Robert Hatlelid, M.D.
• Marsha Aaliyah Hatley, MD
• Katey Hatter, DC
• Krystle Hatton, EMT-P, CJT
• Lisa Terrell Hatz, LCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; 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.