Dr Rafi Kevorkian LLC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

108134 Issued in MO

Legal business name

DR RAFI KEVORKIAN LLC

Practice address

3760 S Lindbergh Blvd
Suite 101
Saint Louis, MO 63127-1358

Phone

(636) 634-5865

Fax

(314) 849-5716

NPI assigned

Dec 2, 2008

Organization subpart

No

Name

Dr. Rafi T Kevorkian, MDNPI 1124073630

Title

President

Phone

(636) 634-5865

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rafi Thomas Kevorkian, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Saint Louis, MO
  • NPI 1124073630

  Geriatric Medicine, MO

  Medicare reassignment NPD Authorized official

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

• RTK Geromed Consultant Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 9, 2008.

{
    "created_epoch": "1228176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228780800000",
    "number": "1245475482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3760 S LINDBERGH BLVD",
            "address_2": "SUITE 101",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271358",
            "telephone_number": "636-634-5865",
            "fax_number": "314-849-5716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3760 S LINDBERGH BLVD",
            "address_2": "SUITE 101",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271358",
            "telephone_number": "636-634-5865",
            "fax_number": "314-849-5716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR RAFI KEVORKIAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-02",
        "last_updated": "2008-12-09",
        "status": "A",
        "authorized_official_last_name": "KEVORKIAN",
        "authorized_official_first_name": "RAFI",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "636-634-5865",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MO",
            "license": "108134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RTK Geromed Consultant",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Saint Louis, MO
• Geriatric Medicine (Internal Medicine) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.