NPIMap

Individual provider Active NPI

John Stephen Mulvahill, M.D.

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1205195005
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2015016131 Issued in MO
Practice address
10024 Watson Rd
Saint Louis, MO 63126-1829
Phone
(314) 919-2500
Fax
(314) 919-2577
NPI assigned
May 14, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X BP10043107 TX
Internal Medicine Physician 207R00000X P9234 TX
Internal Medicine Physician 207R00000X 2015016131 MO Primary

Addresses

Primary practice location

10024 Watson Rd
Saint Louis, MO 63126-1829

Mailing address

600 S. Euclid Ave, Campus Box 8303
Washington Univ School of Medicine, Div of Gesiatrics a
Saint Louis, MO 63110
Phone (314) 286-2971

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160322002826 MO Practitioner - Internal Medicine 3870890619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

10024 Watson Rd
Saint Louis, MO 63126-1829
Phone (314) 919-2555

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2015016131MOMDInternal Medicine Physician
BP10043107TXMDInternal Medicine Physician
P9234TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Internal Medicine CurrentSince Jun 12, 2017 Accepting new patients

Locations

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

10024 Watson Rd
Saint Louis, MO 63126
Phone (314) 919-2273

4438 S Lindbergh Blvd
Saint Louis, MO 63127
Phone (314) 635-5010

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

Interoperability endpoints

  • Direct secure messaging: jmulvahill805417@directc.mercy.net

Organizations & group practices 1

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1336953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1205195005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S. EUCLID AVE, CAMPUS BOX 8303",
            "address_2": "WASHINGTON UNIV SCHOOL OF MEDICINE, DIV OF GESIATRICS A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63110",
            "telephone_number": "314-286-2971",
            "fax_number": "314-286-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10024 WATSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631261829",
            "telephone_number": "314-919-2500",
            "fax_number": "314-919-2577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULVAHILL",
        "first_name": "JOHN",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10043107",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P9234",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2015016131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.