Individual provider Active NPI

Lewis Colnon Vollmar, M.D.

  • Dermatology Physician
  • Saint Louis, MO
National Provider Identifier
1215094677
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD34614 Issued in MO
Practice address
10004 Kennerly Rd
Suite 300
Saint Louis, MO 63128-2141
Phone
(314) 842-4840
Fax
(314) 842-4951
NPI assigned
Jan 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD34614 MO Primary

Addresses

Primary practice location

10004 Kennerly Rd
Suite 300
Saint Louis, MO 63128-2141

Mailing address

10004 Kennerly Rd
Suite 300
Saint Louis, MO 63128-2141
Phone (314) 842-4840

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080919000039 MO Practitioner - Dermatology 9032286992 Practice locations: St Louis, MO

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Missouri, Columbia School of Medicine, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10004 Kennerly Rd
103A
Saint Louis, MO 63128-2173
Phone (314) 842-4840

Hospital & facility affiliations

  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision31
Removal of skin lesions369
Removal or shaving of skin growth12
Skin biopsy74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD34614MOMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Louis Connectcare Dermatology Past Accepting new patients

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 1

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215094677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD",
            "address_2": "SUITE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282141",
            "telephone_number": "314-842-4840",
            "fax_number": "314-842-4951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD",
            "address_2": "SUITE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282141",
            "telephone_number": "314-842-4840",
            "fax_number": "314-842-4951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOLLMAR",
        "first_name": "LEWIS",
        "middle_name": "COLNON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "MD34614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.